The nurse is caring for a male client with a diagnosis of chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency?
A. Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin E
Correct Answer: B. Vitamin B12
Chronic gastritis causes deterioration and atrophy of the lining of the stomach, leading to the loss of the function of the parietal cells. The source of the intrinsic factor is lost, which results in the inability to absorb vitamin B12. This leads to the development of pernicious anemia.
Option A: Autoimmune gastritis (pernicious anemia) is the most common cause of severe vitamin B12 deficiency due to food-cobalamin malabsorption in the elderly, nevertheless use of medications, as proton pump inhibitors, histamine H2 blockers, metformin, or cholestyramine can interfere with or reduce vitamin B12 absorption.
Option C: The most common is vitamin B12 deficiency, which results in megaloblastic anemia and iron malabsorption, leading to iron deficiency anemia. However, in recent years the deficiency of several other vitamins and micronutrients, such as vitamin C, vitamin D, folic acid, and calcium, has been increasingly described in patients with chronic gastritis.
Option D: The reduction of intrinsic factor levels results in vitamin B12 malabsorption. Indeed, the intrinsic factor has a key role in binding vitamin B12 in the duodenum and transporting it to the terminal ileum for absorption. More recently, iron deficiency and iron-deficiency anemia have been reported in the setting of CAAG, particularly in younger patients.
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