The client is pregnant and has been told by her physician that she needs cyanocobalamin (Nascobal). She asks the nurse, "Will this hurt my baby?" What is the best response by the nurse?
1. "No, this medication will not hurt your baby as long as you take it with ascorbic acid."
2. "No, this is safe as long as long as you take it in pill form; it is a Pregnancy Category A drug, which means it is safe for your baby."
3. "No, this medication will not hurt your baby as long as you take the pills only in the third trimester."
4. "No, this is safe in either pill or injectable form; it is a Pregnancy Category A drug which means it is safe for your baby."
Correct Answer: 2
Rationale 1: Ascorbic acid affects the stability of cyanocobalamin (Nascobal), and should not be used concomitantly with cyanocobalamin.
Rationale 2: Cyanocobalamin (Nascobal), oral formulation, is a Pregnancy Category A drug, but it is a Pregnancy Category C when used parenterally.
Rationale 3: There is no evidence to support that oral cyanocobalamin (Nascobal) is teratogenic during the first or second trimesters.
Rationale 4: Cyanocobalamin (Nascobal) is a Pregnancy Category C when used parenterally.
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