Question

Chapter 55 Case Study
Ms. B, 65 years old, comes to the neighborhood nursing clinic with complaints of feeling tired all the time.
She tells the nurse that she has tingling and numbness in her hands and feet. Ms. B asks the nurse what
can be done. During the interview with Ms. B, the nurse finds out that she had a total gastrectomy 2 years
ago. Also, she only recently moved to the area and has not followed up with her routine healthcare needs.

What is the most likely cause of Ms. B’s complaints of extreme tiredness? What is most likely the cause of
the numbness and tingling in her hands and feet? Is treatment needed? If so, why?

Ms. B sees a primary care provider for treatment. She subsequently returns to the neighborhood nursing
clinic and tells the nurse she is very concerned because she used to take the B12 supplement by
injection, and now her physician wants her to take it in the form of a nose spray. Ms. B tells the nurse that
the physician must not know the correct treatment and that she will not be fooled into thinking a nose
spray will help her. How should the nurse respond?

How should the nurse respond to Ms. B’s questions about how long she will continue to have numbness
and tingling in her hands and feet?

Answer 1

Following are the answers:

1.The main cause of Ms. B's extreme tiredness is Vitamin B 12 deficiency as she underwent a total gastrectomy leading to pernicious anemia

2. The most likely cause of numbness and tingling is also Vitamin B12 deficiency as one if its functions is to maintain central nervous system.

3. Treatment is definitely needed.

4. If left untreated, it can worsen symptoms and may cause irreverible damage to the nervous system

5. Nasal vitamin B 12 spray is as effective as any other route supplement. Ms. B will only benefit by it and it will also be easy and convenient

6. After initiation of treatment, it will take days to weeks for the tingling symptoms to reduce