The nurse caring for a client receiving cyanocobalamin (vitamin B12) for pernicious anemia would monitor which laboratory values during therapy?
1. Blood urea nitrogen, urine creatinine, and urinalysis
2. Reticulocyte count, erythrocyte, hemoglobin, and hematocrit
3. Liver function studies, including bilirubin, albumin, and alkaline phosphatase
4. Serum sodium, potassium, magnesium, and chloride levels
Correct Answer: 2
Rationale 1: Blood urea nitrogen, urine creatinine, and urinalysis assess renal status but not cyanocobalamin (vitamin B12) in pernicious anemia.
Rationale 2: Vitamin B12 is essential for maturation of blood cells, which can be assessed by monitoring the client's reticulocyte counts, erythrocyte, hemoglobin, and hematocrit.
Rationale 3: Liver function studies are not used to assess the effectiveness of cyanocobalamin for pernicious anemia.
Rationale 4: Serum sodium, potassium, magnesium, and chloride levels are not affected by vitamin B12.
Global Rationale: Vitamin B12 is essential for maturation of blood cells, which can be assessed by monitoring the client's reticulocyte counts, erythrocyte, hemoglobin, and hematocrit. Renal and liver function would be evaluated but are not directly reflective of treatment for pernicious anemia. Electrolytes are not affected by vitamin B12.
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