VDA

What is the primary consequence of low vitamin B12 and folate levels in the body?

fewer healthy RBCs, leading to VDA

What is another name for vitamin B12 deficiency?

cobalamin deficiency

Vitamin B12 is a water-soluble vitamin acquired through dietary intake of what types of foods?

animal-based foods such as dairy, eggs, meat, and fortified cereals

What glycoprotein, produced in the stomach, is required for the absorption of vitamin B12?

intrinsic factor

In which specific part of the small intestine is vitamin B12 absorbed?

terminal ileum

Vitamin B12 is essential for the synthesis of DNA, _____, and fatty acids.

myelin

A deficiency in vitamin B12 can lead to what two main categories of clinical manifestations?

neuro and hematologic manifestations

Where is excess vitamin B12 stored in the body?

liver

What condition is defined by the autoimmune destruction of gastric parietal cells, resulting in a lack of intrinsic factor?

pernicious anemia

Why can't vitamin B12 be absorbed in pernicious anemia, even with sufficient dietary intake?

because intrinsic factor, which is essential for B12 absorption, is absent

Name a gastrointestinal condition that can cause vitamin B12 deficiency due to malabsorption.

Crohn’s disease; celiac disease; chronic H. pylori infection

Surgical procedures like Roux-en-Y gastric bypass can lead to B12 deficiency by bypassing or removing parts of the stomach that produce what substance?

intrinsic factor

Individuals following which type of diets are at risk for B12 deficiency if they do not use supplements?

strict vegan or vegetarian diets

What lifestyle habit can make the absorption of vitamin B12 more difficult for the body?

excessive alcohol consumption

What class of medications, used for epilepsy, can affect how the body absorbs vitamin B12?

antiseizure meds

The diabetic medication _____ can affect vitamin B12 levels and cause a deficiency.

metformin

What class of medications, given for peptic ulcer disease and GERD, can cause a vitamin B12 deficiency?

PPIs

Clients over what age are at increased risk for vitamin B12 deficiency due to slowed metabolism?

75 yrs

What autoimmune condition, besides pernicious anemia, can make a client up to six times more at risk for B12 deficiency?

Sjogren’s syndrome

In individuals with a diagnosed vitamin B12 deficiency, what specific cause was found to be most prevalent in those with northern European ancestry?

pernicious anemia

Untreated vitamin B12 deficiency can cause deficits in which three areas of well-being?

neuro, physiological, psychological

List two psychological manifestations of vitamin B12 deficiency.

depression; increased irritability; mood changes; or behavior changes

What neurological condition is a concern in clients with vitamin B12 deficiency?

dementia

Newborns of mothers with vitamin B12 deficiency are at risk for what types of birth defects?

developmental delays or spinal cord or brain birth defects

Damage to _____ due to vitamin B12 deficiency explains neurological deficits like neuropathy and ataxia.

myelin

What serious condition of the spinal cord can result from damaged myelin in B12 deficiency?

subacute combined degeneration of the spinal cord

Why are clients with vitamin B12 deficiency at a greater risk of falls and injury?

may suffer neuro deficits like ataxia, neuropathy, and visual deficits

In older adults, B12 deficiency becomes more common due to factors like gastric atrophy and decreased _____ production.

intrinsic factor

Name one of the five common manifestations shared by both vitamin B12 deficiency anemia and iron deficiency anemia.

fatigue; SOB; headaches; pallor; dizziness

What type of symptom may occur if vitamin B12 deficiency goes untreated and progresses to affect the brain and nerves?

difficulty walking; tingling/pain in extremities; confusion; forgetfulness; irritability; visual deficits; diarrhea; weight loss

What is the primary method for diagnosing vitamin B12 deficiency?

blood test

What is the expected reference range for serum vitamin B12 in the blood?

160-950 pg/mL

Besides serum B12 levels, what other factors are required to confirm a diagnosis of B12 deficiency?

analysis of Hgb levels, health history, and physical manifestations

In clients with systemic sclerosis (SSc), what gastrointestinal issue can impair nutrient uptake and lead to B12 deficiency?

SIBO and malabsorption

In clients with SSc, deficiencies in folate and vitamin B12 are associated with elevated levels of what substance, which is a cardiovascular risk factor?

homocysteine

Is there a direct relationship between vitamin B12 deficiency and disseminated intravascular coagulation (DIC)?

no, they are not interrelated

How can pernicious anemia indirectly increase the risk of hypovolemic shock?

increases gastric cancer risk, which can cause hemorrhage and lead to hypovolemia

What bacterial infection is linked with gastritis that impairs B12 absorption and can cause gastric ulcers?

H. pylori

Exposure to what environmental contaminant can interfere with heme synthesis and impair iron absorption, exacerbating anemia?

lead contamination

What safety issue, which can affect a client's ability to ambulate and perform daily activities, can occur if B12 deficiency is untreated?

peripheral neuropathy

Neurological damage from untreated vitamin B12 deficiency may become _____, highlighting the need for early intervention.

irreversible

Name a food group that is a good source of vitamin B12.

red meats, poultry, dairy products, eggs, or fish

Besides animal products, where can clients find vitamin B12 in their diet?

in fortified products like some breakfast cereals and plant-based milks

What is a key difference in the clinical presentation of B12 deficiency anemia compared to iron deficiency anemia?

B12 deficiency may present with neuro symptoms like paresthesias or gait disturbances

In the nursing process for B12 deficiency, what is the first step?

assessment: obtain a comprehensive history and physical exam

During the 'Recognize Cues' step, what specific physical findings should a nurse assess for in a client with suspected B12 deficiency?

pallor; glossitis; dizziness; fatigue; and neuro changes

What action does the nurse take in the 'Analyze Cues' step of the nursing process?

analyze VS, O2 sat, skin condition, and diet

What is the focus of the 'Prioritize Hypotheses' step in the nursing process?

prioritize the most critical issue and collaborate with the care team and the patient

During the 'Generate Solutions' (Planning) phase, what is a key intervention for managing fatigue?

discussing taking breaks throughout the day

What should the nurse provide the client during the 'Take Actions' (Implementation) phase to aid recall of the care plan?

a written copy of the plan to take home and reference

The 'Evaluate Outcomes' phase involves following up with the client to review the plan of care and discuss what?

diet, f/u appts, and when to contact provider

Name one method of administering vitamin B12 supplements.

IM injection, nasal spray, gel, or an oral supplement

What potential local side effect can occur with an intramuscular injection of vitamin B12?

some local irritation

Explain why an older adult client over the age of 75 is at an increased risk of developing vitamin deficiency anemia.

factors include gastric atrophy, decreased intrinsic factor production, slowed metabolism, or taking meds like metformin or PPIs that impair absorption

A nurse is assessing a client with vitamin deficiency anemia. Which of these manifestations are expected: fatigue, shortness of breath, visual deficits, fever, peripheral neuropathy?

fatigue; SOB; visual deficits; and peripheral neuropathy