Medical Surgical Pernicious anemia #2

Question

A client diagnosed with pernicious anemia asks the nurse how she will be treated for the anemia. Which answer by the nurse is best?

Answers

  1. “You will receive an intravenous infusion of packed red blood cells and platelets.”
    • Rationale:

      This answer is not correct because infusion of packed red blood cells and platelets is the treatment plan for aplastic anemia. This provides blood cells the bone marrow is not producing.

  2. “Once the source of your bleeding is found, we will plan and treat accordingly.”
    • Rationale:

      This answer is not correct because the source of pernicious anemia lies in the lack of intrinsic factor production. With iron deficiency anemia, the particular cause of the deficiency and bleeding is treated.

  3. “Treatment will consist of intramuscular B12 injections every 1 to 3 months.”
    • Rationale:

      This answer is correct because treatment with B12 injections are intramuscular. The B12 goes directly into the bloodstream through the muscle, rather than the gastrointestinal route where there is no intrinsic factor being produced. Sometimes the client will also be prescribed oral supplementation of folate as well.

  4. “Eat a healthy diet high in protein and iron with an abundance of fresh vegetables.”
    • Rationale:

      This answer is not correct because pernicious anemia cannot be controlled by diet alone due to vitamin B12 not being absorbed properly in the intestines due to lack of intrinsic factor. But eating a healthy diet high in protein and iron with fresh vegetables unless otherwise contraindicated by the provider is a great intervention in addition to B12 injections.

Overview

Pernicious anemia is caused by an autoimmune process that makes a client unable to produce the intrinsic factor which binds vitamin B12 so that it can be absorbed in the intestines. For this reason, intramuscular injections of B12 is the preferred method of treatment.

Explanation

Learning Outcomes

Pernicious anemia results when a client is unable to produce the intrinsic factor which binds vitamin B12 so that it can be absorbed in the intestines. For this reason, intramuscular injections of B12 is the preferred method of treatment. The B12 goes directly into the bloodstream through the muscle, rather than the gastrointestinal route where there is no intrinsic factor being produced. With aplastic anemia, blood transfusion provides blood cells the bone marrow that is not producing. The specific cause of blood loss from iron deficiency anemia is what is treated to supplement the iron loss. Pernicious anemia cannot be controlled by diet alone due to vitamin B12 not being absorbed properly in the intestines. A diet high in protein and iron can be helpful in those with anemia unless otherwise contraindicated by the provider.

Test Taking Tip

Have knowledge of the different types of anemias, their causes, and their treatments.

Video Rationale