Alterations in Oxygen Transport: Pernicious Anemia

The paper “Alterations in Oxygen Transport: Pernicious Anemia” is a good example of a case study on nursing. This paper uses a case scenario involving a 56-year old patient to develop a comprehensive understanding of pernicious anemia. This autoimmune disorder is one of the most common causes of cobalamin (vitamin B12) deficiency in the world and is historically typified by gastric mucosal atrophy, discriminatory loss of parietal and chief cells from the gastric mucosa, as well as submucosal lymphocytic,  infiltrate (Kumar, 2007). It is of immense importance for the nursing practitioner (NP) to ask the patient about paresthesias and ataxia as these two sensory abnormalities underscore deficiencies of vitamin B12 in patients (Kumar, 2007). Owing to the fact that vitamin B12 deficiency causes pernicious anemia, the NP will be better placed to verify a diagnosis of pernicious anemia if the patient reports sensations of tingling, numbness, crawling, deadness, constriction in the abdomen and chest, or gait abnormalities. In terms of pathophysiology, vitamin B12 is an important component in the formation of red blood cells (erythrocytes) which are required to transport oxygen from the lungs to other organs of the body. Patients with paresthesias and ataxia (e.g., unsteady gait, numbness, etc) are likely to have a vitamin B12 deficiency as this important vitamin is needed for the proper functioning and health of nerve tissue.Alterations in Oxygen Transport: Pernicious Anemia As such, knowledge of whether the patient has episodes of paresthesias and/or ataxia will be instrumental in identifying vitamin B12 deficiency, which in turn is known to cause pernicious anemia (Rote & McCane, 2014; Toh & Alderuccio, 2014). Research has demonstrated that individuals suffering from pernicious anemia are unable to generate adequate amounts of IF (intrinsic factor) in their stomach to aid in the absorption of vitamin B12 which is needed to make red blood cells (Toh & Alderuccio, 2014). As such, individuals with pernicious anemia need to be facilitated to absorb vitamin B12 using other mechanisms due to the incapacity of IF to bind vitamin B12 and also to assist in its absorption.