Vitamin B12 Anemia

Question 1

Pathophysiology

Answer 1

Pernicious anemia caused by lack of intrinsic factor (substance secreted by stomach that helps B12 absorption)
Neurological and psychiatric dysfunctions due to nerve atrophy

Question 2

Clinical manifestations

Answer 2

Peripheral neuropathy
Altered mental status
Depression
May exhibit CM of other types of anemia, such as tachycardia/pnea, SOB, dizziness
Lhermitte’s sign (electric shock sensation produced by neck flexion - rare)

Question 3

Diagnosis

Answer 3

Labs (CBC initial. MMA for more specificity)

Question 4

Nursing intervention

Answer 4

Vital signs
Neurological assessment
Fall risk
I/O
Monitor use of folic acid (will mask B12 deficiency)
Monitor use of NO for anesthesia - will inactivate B12

Question 5

Patient teaching

Answer 5

Diet education
Prenatal teaching