Vitamin B- Nutrition Case Study Nursing Assignment Paper

This week's discussion revolves around the following case study: Valerie is a 38 year-old woman who underwent laparoscopic proximal gastric bypass surgery (about the surgery) 6 months ago without any post-operation complications. Since then she has lost more than 40 lb. After the surgery, her doctor gave her lansoprazole, which prevents stomach acid production. She was also asked to work with a dietitian to learn how to select and prepare foods, create a menu that works for her, and to take daily multivitamin supplement, which Valerie did for about 4 months. As Valerie saw the satisfying effects of weight loss and got used to the new routine, she felt she had learned enough knowledge and skills regarding how to choose health foods and go on with live her life after gastric bypass. She believed her diet was healthy and balanced and stopped taking multivitamins. Three weeks ago, Valerie started to have dizziness. Her appetite decreased, and sometimes she vomited. She went to the ER and was found to have tachycardia and dehydration. This led to an initial diagnosis of gastric outflow obstruction, which was not uncommon for patients who underwent gastric bypass. However, this diagnosis could NOT be confirmed by endoscopic examination. Lab tests were consistent with dehydration with normal levels of vitamin B12, iron, zinc, thyroid function and CBC, so she was admitted and administered intravenous fluids with glucose and was given high-sugar energy drinks. The next day, Valerie collapsed in the shower due to light-headedness, and had an extremely low blood pressure. She was later observed to show abnormal eye movement, hyperreflexia in her arms, weakness in thighs, and reduced touch sensation. In this discussion, we will focus on the assessment and diagnosis of the patient's condition. Here are some guiding questions: - What do you think contributed to the patient's condition? - How would you explain the progression of the patient's condition? - Based on the information presented in the scenario, what diagnosis regarding micronutrients might you reach? - Is there any alternative diagnosis that you should like to consider? Why? - What additional information including patient history and lab tests would you like to have to help the assessment and diagnosis? As always, please provide evidence and references to support your discussion and focus the discussion on the course content as opposed to general opinions or knowledge on the topic.