A nurse is caring for a patient with vitamin B12 deficiency anemia.
The patient is prescribed vitamin B12 supplementation.
What is the appropriate route and dosage of vitamin B12 for a patient with pernicious anemia or severe malabsorption?

Choice A rationale:

Oral supplements are less effective in raising vitamin B12 levels.

Rationale: Vitamin B12 deficiency anemia often results from malabsorption issues in the gastrointestinal tract, where the body cannot adequately absorb vitamin B12 from the digestive system.

In such cases, oral supplements may not be effective because they rely on the digestive system for absorption.

In contrast, vitamin B12 injections bypass the gastrointestinal tract, delivering the vitamin directly into the bloodstream, ensuring absorption, and increasing the effectiveness of treatment.

Choice B rationale:

Injections are less painful for the client.

Rationale: While the pain associated with injections can vary from person to person, it is not the primary reason for choosing injections over oral supplements in the treatment of vitamin B12 deficiency anemia.

The primary consideration is the effectiveness of absorption, as discussed in Choice A's rationale.

Choice C rationale:

Injections have fewer side effects.

Rationale: Both oral supplements and vitamin B12 injections have their own set of potential side effects, but the choice between the two primarily depends on the underlying cause of the deficiency and the ability to absorb vitamin B12.

Therefore, the assertion that injections have fewer side effects is not the primary reason for choosing them.

Choice D rationale:

Oral supplements may cause gastrointestinal distress.

Rationale: This is the correct answer.

Oral supplements of vitamin B12 may cause gastrointestinal distress, particularly in individuals with gastrointestinal issues.

These supplements can be hard for some individuals to tolerate, leading to discomfort, gas, or other gastrointestinal symptoms.

This is a significant consideration when choosing the route of administration for vitamin B12 treatment.

Choice A rationale:

Assessing vital signs is important for overall patient assessment, but it is not the most crucial aspect when identifying signs of pallor or jaundice.

Vital signs help in evaluating the patient's general condition and stability.

Choice B rationale:

Heart sounds are important for assessing cardiac function and may provide information on the patient's cardiovascular status, but they are not the most crucial aspect when identifying signs of pallor or jaundice.

Choice C rationale:

Lung sounds are essential for evaluating the respiratory status of the patient, but they do not directly help in identifying signs of pallor or jaundice.

Choice D rationale:

The correct choice is D.

When assessing a patient with suspected vitamin B12 deficiency anemia, it is crucial to examine the skin, mucous membranes, and eyes.

Pallor (pale skin) and jaundice (yellowing of the skin and eyes) are common signs of anemia, and these can be detected through the inspection of the skin, mucous membranes (such as the inside of the mouth), and the whites of the eyes (sclera)

These signs are indicative of an underlying health issue, and identifying them is essential for the diagnosis and management of anemia.