The nurse is taking a medication history on a newly admitted ...

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The nurse is taking a medication history on a newly admitted patient. The patient reports taking folic acid and vitamin B12. The nurse notifies the provider because of the concern that folic acid can:
 
  a. cause fetal malformation.
  b. mask the signs of vitamin B12 deficiency.
  c. negatively affect potassium levels.
  d. worsen megaloblastic anemia.

Question 2

A patient with vitamin B12 deficiency is admitted with symptoms of hypoxia, anemia, numbness of hands and feet, and oral stomatitis. The nurse expects the prescriber to order which of the following therapies?
 
  a. IM cyanocobalamin and folic acid
  b. IM cyanocobalamin and antibiotics
  c. PO cyanocobalamin and folic acid
  d. PO cyanocobalamin and blood transfusions

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Answer to Question 1

ANS: B
Folic acid can reverse the hematologic effects of vitamin B12 deficiency, but it does not reverse the neurologic effects so it is important to determine the degree of B12 deficiency in order to treat it. Folic acid does not cause fetal malformation; in fact, it can help prevent neural tube defects. Folic acid does not worsen megaloblastic anemia. Folic acid does not affect potassium levels.

Answer to Question 2

ANS: A
This patient is showing signs of more severe vitamin B12 deficiency with neurologic symptoms; therefore, cyanocobalamin should be given parenterally along with folic acid. Antibiotics are indicated only when signs of infection are present. Oral cyanocobalamin is not recommended.

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TY

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