Answer to Question 1
The most common cause of thiamin deficiency in the United States is alcoholism. Alcohol affects thiamin uptake and other aspects of thiamin utilization, and these effects may contribute to the prevalence of thiamin deficiency in alcoholics. The major manifestations of thiamin deficiency in humans involve the cardiovascular and nervous systems. The Wernicke-Korsakoff syndrome is characterized by weakness of eye movements, gait disturbance (ataxia), and confusion. Korsakoff's psychosis is characterized initially by anterograde amnesia, retrograde amnesia to a lesser extent, a disordered time sense, and often confabulation of the acute senses. Cognitive deficits have also been observed. Ophthalmoplegia in Wernicke's encephalopathy responds rapidly to thiamin administration, while the ataxia and confusion respond more slowly. The rapidity of response depends on the conversion of thiamin to its active form in the liver; patients with advanced liver disease such as cirrhosis may therefore have a delayed response.
Answer to Question 2
b
A nurse communicates with her non–English-speaking patient through an interpreter
Patient teaching: abdominal assessment
Instructing a Patient on Breast Self-Examination
Sandwich or capture enzyme immunoassay for patient IgM (double capture: IgM capture, Ag capture).
Patient Physical Status Classification