A nurse is responsible for the follow-up care of a client with vitamin B12 deficiency anemia.
Which of the following assessments should the nurse prioritize to monitor the effectiveness of treatment?
Monitoring blood glucose levels.
Checking urine for protein.
Regular blood tests to check hemoglobin and vitamin B12 levels.
Measuring bone density.
The Correct Answer is C
Choice C rationale:
Regular blood tests to check hemoglobin and vitamin B12 levels should be prioritized to monitor the effectiveness of treatment for vitamin B12 deficiency anemia.
Monitoring hemoglobin levels can assess the improvement in anemia, while monitoring vitamin B12 levels can confirm that the deficiency is being adequately corrected.
Regular blood tests provide objective data on the client's response to treatment and help healthcare providers adjust the treatment plan if needed.
Choice A rationale:
Monitoring blood glucose levels is not a priority assessment for monitoring the effectiveness of treatment for vitamin B12 deficiency anemia.
While vitamin B12 deficiency can lead to neurological symptoms and affect glucose metabolism, the primary focus of monitoring in this context should be on anemia-related parameters, such as hemoglobin and vitamin B12 levels.
Choice B rationale:
Checking urine for protein is not a relevant assessment for monitoring the effectiveness of treatment for vitamin B12 deficiency anemia.
Proteinuria is a finding associated with kidney dysfunction and is not directly related to the evaluation of anemia or vitamin B12 deficiency.
Choice D rationale:
Measuring bone density is not a priority assessment for monitoring the effectiveness of treatment for vitamin B12 deficiency anemia.
Bone density assessment is typically used to evaluate bone health and the risk of osteoporosis, which is not a primary concern in the context of vitamin B12 deficiency anemia.
The focus should be on hematological parameters and neurological symptoms associated with the deficiency.
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Correct Answer is B
Explanation
Serum vitamin B12 level.
Choice A rationale:
Serum folate level does not confirm vitamin B12 deficiency anemia.
While both vitamin B12 and folate deficiencies can lead to similar types of anemia (macrocytic and hypochromic), measuring serum folate levels alone will not confirm the diagnosis of vitamin B12 deficiency anemia.
Choice B rationale:
The correct answer is choice B.
A serum vitamin B12 level test is a crucial diagnostic tool for confirming vitamin B12 deficiency anemia.
In this case, where the client presents with macrocytic (large) and hypochromic (pale) RBCs with low hemoglobin (Hgb) and hematocrit (Hct) levels and an elevated mean corpuscular volume (MCV) above 100 fL, a low serum vitamin B12 level would confirm the diagnosis.
Choice C rationale:
Serum homocysteine level can be elevated in cases of vitamin B12 deficiency, but it is not a specific test for confirming the diagnosis of vitamin B12 deficiency anemia.
It may be used as an additional marker, but it should not be the primary test for confirmation.
Choice D rationale:
Reticulocyte count measures the percentage of young, immature red blood cells in the blood and is not a specific test for confirming vitamin B12 deficiency anemia.
While anemia is present in this case, it does not provide direct information about the underlying cause, which is best confirmed by measuring serum vitamin B12 levels.
Correct Answer is D
Explanation
They are neuropsychiatric symptoms associated with vitamin B12 deficiency anemia.
Choice A rationale:
These neuropsychiatric symptoms are actually related to vitamin B12 deficiency anemia.
Vitamin B12 deficiency can lead to neurological symptoms, including confusion, irritability, and depression.
It is not unrelated to the condition.
Choice B rationale:
Gastrointestinal symptoms are not the primary manifestation of vitamin B12 deficiency anemia.
Choice C rationale:
Glossitis is a common sign of vitamin B12 deficiency anemia, but it primarily involves inflammation and changes in the tongue.
While glossitis is associated with vitamin B12 deficiency, it does not fully explain the neuropsychiatric symptoms mentioned in the question.
Choice D rationale:
The correct answer is choice D.
Neuropsychiatric symptoms such as confusion, irritability, and depression are indeed associated with vitamin B12 deficiency anemia.
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