A client with vitamin B12 deficiency anemia is receiving dietary education and counseling.
What foods should the nurse encourage the client to consume to increase their vitamin B12 intake?

Choice A rationale:

The nurse should encourage the client with vitamin B12 deficiency anemia to consume foods rich in vitamin B12.

Meat, poultry, fish, eggs, and fortified cereals are excellent sources of vitamin B12.

Including these foods in the diet can help increase vitamin B12 intake and support the treatment of the deficiency.

Choice B rationale:

Fruits and vegetables high in vitamin C are not directly related to increasing vitamin B12 intake.

Vitamin C is essential for iron absorption, but it does not provide vitamin B12.

Encouraging the consumption of vitamin C-rich foods is important for iron-deficiency anemia, not vitamin B12 deficiency anemia.

Choice C rationale:

Dairy products and nuts are not primary sources of vitamin B12.

While they offer other essential nutrients, they do not provide significant amounts of vitamin B12.

Therefore, they should not be the primary focus when trying to increase vitamin B12 intake.

Choice D rationale:

Foods high in iron and calcium, while important for overall health, are not the primary focus when addressing vitamin B12 deficiency anemia.

Iron and calcium-rich foods are more relevant to iron-deficiency anemia and bone health, respectively.

The primary focus for vitamin B12 deficiency anemia should be on foods rich in vitamin B12, as mentioned in choice A.

Choice A rationale:

Administering 500 mcg of cyanocobalamin intramuscularly daily for a week, then monthly for life is the appropriate route and dosage for a patient with pernicious anemia or severe malabsorption.

Intramuscular injection is the preferred route for patients with impaired absorption of vitamin B12, as it ensures direct absorption into the bloodstream.

The initial daily dose helps replenish depleted stores, and the monthly maintenance dose is required to prevent recurrence.

Choice B rationale:

Administering 1000 mcg of cyanocobalamin orally daily for a week, then weekly for a month, then monthly for life is not the best choice for patients with pernicious anemia or severe malabsorption.

Oral vitamin B12 is not effective in these cases because the underlying issue is the inability to absorb vitamin B12 from the gastrointestinal tract.

Intramuscular administration bypasses this problem.

Choice C rationale:

Administering 1000 mcg of cyanocobalamin intramuscularly daily for a week, then monthly for life is a reasonable option, but it is not as effective as the regimen described in choice A.

The initial daily dose is lower, and there is no weekly dosing phase to replenish stores quickly.

Choice D rationale:

Administering 2000 mcg of cyanocobalamin subcutaneously daily for a week, then monthly for life is not the preferred route for vitamin B12 supplementation in patients with pernicious anemia or severe malabsorption.

Intramuscular injection is the preferred route as it ensures better absorption, and subcutaneous injection may not be as effective.