Pernicious anemia
Structured condition card with NCLEX priority cues and nursing action focus.
Pernicious anemia
Also testable as: Vitamin B12 deficiency anemia, Cobalamin deficiency anemia
Etiology / Pathophysiology
- Impaired vitamin B12 absorption from lack of intrinsic factor; risk also rises with gastric surgery, malabsorption, strict vegan diet, metformin, or long-term acid suppression.
- B12 deficiency impairs DNA synthesis and myelin maintenance, causing megaloblastic anemia and neurologic symptoms.
Medications
| Class | Why it matters |
|---|---|
| GI acid reducers | Long-term acid suppression can contribute to B12 monitoring concerns. |
Signs / symptoms
- B12 deficiency can cause neurologic changes; folate alone can mask anemia while neuro injury continues.
- Intrinsic factor matters for absorption.
Nursing actions
- Assess fatigue, pallor, glossitis, paresthesias, gait changes, diet, and GI surgery history.
- Teach B12 replacement route and schedule as ordered; neurologic symptoms need early reporting.
- Trend CBC, MCV, B12, folate, and neurologic findings when ordered.
Complications
- Neuropathy
- Falls
- Cognitive change
- Severe anemia
NCLEX cues
- B12 deficiency can cause neurologic changes; folate alone can mask anemia while neuro injury continues.
- Intrinsic factor matters for absorption.
Memory hooks
- B12 builds blood and nerves.
Labs / Diagnostics
- CBC with MCV
- Vitamin B12
- Folate
- Methylmalonic acid when ordered
Review notes
- Needs review.
Cross references
Related cards are generated from the shared study map, not hand-built per page.
Condition card for Pernicious anemia: recognize the testable cue, prevent the complication, and choose the safest first nursing action.
Folate and B12 both affect RBC formation; B12 also affects nerves.
Inflamed, smooth, or swollen tongue.
Long-term metformin therapy can be associated with reduced B12 levels.
Reduces stomach acid so irritated tissue can heal and reflux symptoms decrease.
Water-soluble B vitamin needed for DNA synthesis and fetal neural tube development.
Water-soluble vitamin needed for red blood cell production and neurologic function.