Question

The husband of an older woman, diagnosed with pernicious anemia, calls the clinic to report that his wife still has memory loss and some confusion since she received the first dose of nasal cyanocobalamin two days ago. He tells the nurse that he is worried that she might be getting Alzheimer's disease. What action should the nurse take?

Answer 1

The nurse should report the symptoms of memory loss and confusion to the physician, as they might signify side effects or other underlying causes beyond pernicious anemia. The healthcare provider may need to perform additional assessments or adjust the treatment plan.

Step-by-step explanation:

When an older woman diagnosed with pernicious anemia experiences memory loss and confusion after the first dose of nasal cyanocobalamin, the nurse's priority action should be to convey these concerns to the treating physician immediately. Pernicious anemia, which is poor absorption of vitamin B12, can lead to neurological symptoms due to the role of B12 in nerve function and brain health. It's important to differentiate the causes of cognitive dysfunction as they could be related to vitamin B12 deficiency or other conditions such as Alzheimer's disease.

Cognitive changes could also relate to stress, illness, or medication side effects. The husband's observations, such as the issues with memory and irritability, are valuable in creating a complete clinical picture. The healthcare provider might decide to assess the woman further, perhaps including cognitive tests or even imaging, to rule out other causes like Alzheimer's or brain tumors, and to monitor how well the B12 treatment is working.