Question

The client had stomach cancer and a surgical removal of his stomach several years ago. The physician prescribed cyanocobalamin (Crystamine). The client stopped this drug several months ago. What will the nurse most likely assess in this client?

1. Memory loss, numbness in the limbs, and depression
2. A gradual decrease in red blood cell counts
3. Jaundice, and tarry stools
4. Low hemoglobin and hematocrit counts

Answer 1

Discontinuation of cyanocobalamin in a client with stomach removal is likely to lead to pernicious anemia, causing symptoms like memory loss, numbness in limbs, and depression, along with low hemoglobin and hematocrit counts due to vitamin B12 deficiency.

Step-by-step explanation:

In a client who had stomach cancer and underwent surgical removal of his stomach, leading to a reliance on cyanocobalamin (Crystamine) injections due to impaired vitamin B12 absorption, discontinuation of this medication would most likely result in pernicious anemia. The nurse is likely to assess symptoms associated with vitamin B12 deficiency, including memory loss, numbness in the limbs, and depression. These symptoms are indicative of neurological impairment and hematological dysfunctions that can occur when B12 levels fall due to the lack of intrinsic factor normally produced by the stomach, which is essential for B12 absorption.

Other concerns that may arise due to the discontinuation of cyanocobalamin include low hemoglobin and hematocrit counts, which are signs of the anemia that can result from vitamin B12 deficiency. This condition, if left untreated, could lead to further complications including increased fatigue, muscle weakness, and in severe cases, irreversible neurological damage.