Question 1 A 52-year-old male IV drug user was diagnosed with hepatitis C 5 years ago He is now experiencing impaired blood clotting The nurse suspects a decrease in which of the following vitamins? a. K b. D c. E d. B12 Question 2 A 5-year-old male was diagnosed with normocytic-normochromic anemia Which of the following anemias does the nurse suspect the patient has? a. Sideroblastic anemia b. Hemolytic anemia c. Pernicious anemia d. Iron deficiency anemia Question 3

The nurse should suspect a decrease in vitamin K in the 52-year-old male IV drug user experiencing impaired blood clotting. Vitamin K is essential for the synthesis of clotting factors in the liver, and a deficiency in this vitamin can lead to impaired blood clotting (Rost, 2019). IV drug use can increase the risk of viral hepatitis, including hepatitis C, which can cause liver damage and impair the liver’s ability to produce clotting factors (Sethi & Mishra, 2012). Therefore, it is likely that the patient’s impaired blood clotting is due to a decrease in vitamin K.

Vitamin D deficiency is not associated with impaired blood clotting. Instead, vitamin D is primarily involved in calcium regulation and bone health (Holick, 2007). Vitamin D deficiency can lead to conditions such as rickets in children and osteomalacia in adults. However, it does not directly affect blood clotting.

Vitamin E deficiency is also not associated with impaired blood clotting. Vitamin E is a fat-soluble vitamin with antioxidant properties, and its deficiency can lead to neurological abnormalities and muscle weakness (Traber, 2006). However, it has no direct effect on blood clotting.

Vitamin B12 deficiency (choice D) is unlikely to be the cause of impaired blood clotting in this patient. Vitamin B12 is primarily involved in the production of red blood cells and the maintenance of the nervous system (Herbet, 1988). Vitamin B12 deficiency can lead to megaloblastic anemia and neurological symptoms. It does not directly affect blood clotting.

In summary, the nurse should suspect a decrease in vitamin K as the cause of impaired blood clotting in the 52-year-old male IV drug user.

Question 2:

The nurse should suspect iron deficiency anemia in the 5-year-old male diagnosed with normocytic-normochromic anemia. Normocytic-normochromic anemia is characterized by red blood cells that are of normal size (normocytic) and have a normal hemoglobin content (normochromic) (Kaferle & Strzoda, 2013). Iron deficiency is the most common cause of this type of anemia, especially in young children. Iron is essential for the synthesis of hemoglobin, the protein in red blood cells that carries oxygen (Camaschella, 2015). A deficiency in iron can lead to a decrease in hemoglobin levels and subsequent anemia.

Sideroblastic anemia (choice A) is characterized by abnormal red blood cell precursors in the bone marrow called sideroblasts (Kaferle & Strzoda, 2013). This type of anemia can be caused by genetic mutations or acquired conditions such as lead poisoning or alcohol abuse. It is not typically associated with normocytic-normochromic anemia.

Hemolytic anemia (choice B) is characterized by the premature destruction of red blood cells (Kaferle & Strzoda, 2013). It can be caused by inherited conditions such as sickle cell disease or acquired conditions such as autoimmune diseases. Hemolytic anemia typically presents with smaller and paler red blood cells, known as microcytic-hypochromic anemia, rather than normocytic-normochromic anemia.

Pernicious anemia (choice C) is caused by a deficiency in vitamin B12, which is necessary for the synthesis of red blood cells (Stabler, 2013). Pernicious anemia typically presents with larger red blood cells, known as macrocytic anemia, rather than normocytic-normochromic anemia.

In summary, the nurse should suspect iron deficiency anemia in the 5-year-old male diagnosed with normocytic-normochromic anemia. Iron deficiency is the most common cause of this type of anemia in children.