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Mobile App Chapter 23: Problem 57
The nurse is caring for a client after a gastrectomy. Which of the following vitamins will the nurse expect to be administered throughout the client's lifespan? A. Phytonadione (vitamin \(\mathrm{K}\) ) B. Cyanocobalamin (vitamin B 12) C. Thiamine (vitamin B1) D. Ascorbic acid (Ascorba-cap)
Short Answer
Expert verified
Answer: Vitamin B12 (Cyanocobalamin)
Step by step solution
01
Understand the consequences of a gastrectomy
A gastrectomy is a surgical procedure to remove part or all of the stomach. This can lead to altered digestion and absorption of nutrients, including vitamins. Understanding the functions and sources of each vitamin will help us determine which one is most likely to be needed post-gastrectomy.
02
Analyze the functions and sources of each vitamin
A. Phytonadione (vitamin K) is essential for blood clotting, and it is found in green leafy vegetables, certain vegetable oils, and some meats. It is produced by gut bacteria, which may be affected by gastrectomy, but can still be obtained through diet.
B. Cyanocobalamin (vitamin B12) is important for red blood cell formation, DNA synthesis, and proper nerve function. It is found only in animal products like meat, poultry, fish, eggs, and dairy. Vitamin B12 absorption typically occurs in the stomach and lower part of the small intestine, which might get altered after a gastrectomy.
C. Thiamine (vitamin B1) is involved in carbohydrate metabolism, nerve function, and the production of ATP (energy). It is found in whole grains, meat, and fish. Gastrectomy might affect the absorption of thiamine, but it can still be obtained through diet.
D. Ascorbic acid (Ascorba-cap) is essential for collagen formation, wound healing, and immune function. It is found in fruits and vegetables, and can still be consumed through a regular diet after gastrectomy.
03
Determine which vitamin will be administered throughout the client's lifespan
Based on the analysis of each vitamin's functions and sources and considering the consequences of gastrectomy, the most likely vitamin to be administered throughout the client's lifespan is:
B. Cyanocobalamin (vitamin B12)
This is because the proper absorption of vitamin B12 is more likely to be affected by gastrectomy compared to the other vitamins listed, and it cannot be obtained from non-animal sources, making supplementation necessary for clients who undergo a gastrectomy.
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Key Concepts
These are the key concepts you need to understand to accurately answer the question.
Cyanocobalamin (vitamin B12)
Cyanocobalamin, better known as vitamin B12, is a critical nutrient that supports several key functions within the body. It's essential for the production of red blood cells, proper nerve function, and the creation of DNA. Naturally, vitamin B12 is present in animal products like meats, dairy, and eggs.
Since vitamin B12 absorption normally takes place in the stomach and lower part of the small intestine, its assimilation can be significantly impacted by gastrectomy surgery. With a reduced or non-existent stomach, the intrinsic factor—a protein essential for B12 absorption—is lessened, leading to potential deficiencies. That's why cyanocobalamin supplementation is often prescribed to individuals following a gastrectomy to ensure that they maintain adequate levels of this crucial vitamin.
Since vitamin B12 absorption normally takes place in the stomach and lower part of the small intestine, its assimilation can be significantly impacted by gastrectomy surgery. With a reduced or non-existent stomach, the intrinsic factor—a protein essential for B12 absorption—is lessened, leading to potential deficiencies. That's why cyanocobalamin supplementation is often prescribed to individuals following a gastrectomy to ensure that they maintain adequate levels of this crucial vitamin.
Vitamin Absorption Post-Gastrectomy
After a gastrectomy, patients can face challenges with nutrient absorption, including various vitamins. The change in the structure of the gastrointestinal tract can lead to less efficient digestion and absorption, as certain areas crucial for these processes have been removed or altered. One of its primary impacts is on B12 absorption due to the loss of the intrinsic factor.
Additionally, other vitamins may be absorbed less effectively even if they can be sourced from a wider variety of food groups compared to vitamin B12. For instance, vitamins such as vitamin D, calcium, and iron often require supplementation post-surgery because the altered gut environment can influence how these nutrients are processed and taken up into the body.
Additionally, other vitamins may be absorbed less effectively even if they can be sourced from a wider variety of food groups compared to vitamin B12. For instance, vitamins such as vitamin D, calcium, and iron often require supplementation post-surgery because the altered gut environment can influence how these nutrients are processed and taken up into the body.
Vitamins after Stomach Surgery
Post-gastrectomy care includes a thorough evaluation of dietary habits and nutritional intake to ensure patients receive the necessary vitamins and minerals. Since the ability to consume and absorb certain foods might be compromised, a multivitamin supplement is commonly advised alongside specific vitamins that are more likely to be deficient, like vitamin B12, iron, calcium, and vitamin D.
Patients post-gastrectomy are usually monitored long-term by healthcare providers with regular blood work to assess and prevent nutrient deficiencies. When natural nutritional needs are not met due to surgery, vitamin supplementation becomes a cornerstone of ongoing patient care.
Patients post-gastrectomy are usually monitored long-term by healthcare providers with regular blood work to assess and prevent nutrient deficiencies. When natural nutritional needs are not met due to surgery, vitamin supplementation becomes a cornerstone of ongoing patient care.
Nutrient Deficiency Post-Gastrectomy
Shortly after a gastrectomy, the risk of nutrient deficiency increases significantly because the body loses one of its primary organs for nutrient absorption. Immediate concerns revolve around macronutrients like proteins and fats, as well as micronutrients like certain vitamins and minerals. Symptoms of such deficiencies may include fatigue, anemia, osteoporosis, and neurological issues, depending on the specific nutrient lacking.
Healthcare providers pay special attention to these risks by advising a balanced diet that meets the altered digestion and absorption capabilities and by recommending appropriate vitamin supplements. The goal is to ensure that patients lead a healthy life post-surgery, with a particular focus on preventing deficiencies such as osteoporosis from calcium and vitamin D deficiency or pernicious anemia from B12 deficiency.
Healthcare providers pay special attention to these risks by advising a balanced diet that meets the altered digestion and absorption capabilities and by recommending appropriate vitamin supplements. The goal is to ensure that patients lead a healthy life post-surgery, with a particular focus on preventing deficiencies such as osteoporosis from calcium and vitamin D deficiency or pernicious anemia from B12 deficiency.
