Question

A client who has long-term cholethiasis is being assessed for fat-soluble vitamin deficiencies. Which clinical manifestation would correlate with a deficiency in these vitamins? A. Numbness on the side of the face B. Yellow sclera C. Bleeding gums D. Constipation

Short answer

Answer: C. Bleeding gums

Step-by-step solution

Option A: Numbness on the side of the face

Numbness on the side of the face does not correlate with fat-soluble vitamin deficiencies. It can be a symptom of different conditions such as trigeminal neuralgia, Bell's palsy, or stroke.

Option B: Yellow sclera

Yellow sclera is a sign of jaundice, which usually occurs due to liver problems or hemolytic anemia. It does not directly indicate a deficiency in fat-soluble vitamins.

Option C: Bleeding gums

Bleeding gums can be a sign of vitamin K deficiency. Vitamin K is a fat-soluble vitamin responsible for blood clotting. People with long-term cholethiasis might have vitamin K deficiency, as bile is necessary for the absorption of fat-soluble vitamins.

Option D: Constipation

Constipation is a general symptom that can occur due to various reasons like dehydration, low-fiber diet, or inactivity. It does not specifically indicate a deficiency in fat-soluble vitamins. Based on the analysis above, the correct answer is: C. Bleeding gums

Key concepts

Cholethiasis

Cholethiasis, commonly known as gallstones, refers to the formation of hard deposits within the gallbladder. These deposits can obstruct the flow of bile, leading to a variety of health issues. Bile is essential for the digestion and absorption of fat-soluble vitamins, which include vitamins A, D, E, and K. When cholethiasis impairs bile secretion, the body may not absorb these vitamins effectively, resulting in specific deficiencies.

For instance, a deficiency in vitamin A could lead to night blindness, while inadequate levels of vitamin D might contribute to weak bones and skeletal deformities due to poor calcium absorption. Vitamin E's antioxidant properties protect cells from damage, and its lack may cause neurological problems. Vitamin K is crucial for blood clotting; a deficiency can cause excessive bleeding and is often detected by symptoms such as bleeding gums or easy bruising.

Vitamin K Deficiency

Vitamin K plays a pivotal role in the synthesis of coagulation factors, which are necessary for proper blood clotting. Deficiency in vitamin K can arise from various conditions, including cholethiasis, where the bile duct is blocked, impairing the absorption of this fat-soluble vitamin.

Those with long-term cholethiasis are particularly at risk of developing vitamin K deficiency due to decreased bile flow, which is required for the intestinal absorption of the vitamin. Clinically, vitamin K deficiency may manifest as easy bruising, bleeding gums, nosebleeds, blood in the urine or stool, and excessive menstrual bleeding in women.

Clinical Manifestations

Clinical manifestations of fat-soluble vitamin deficiencies can vary greatly, but they generally concern the systems in the body that these vitamins affect. For example, vitamin A deficiency might result in visual disturbances, while vitamin D deficiency could lead to bone pain and muscle weakness. Vitamin E deficiency might manifest with neurological issues such as muscle weakness or impaired reflexes, and a shortage of vitamin K can significantly affect the body's ability to clot blood, as evidenced by bleeding gums or other hemorrhagic conditions.

Understanding these clinical manifestations is crucial for healthcare providers to correctly identify and treat vitamin deficiencies. It can also help individuals recognize possible vitamin deficiencies in themselves and seek medical attention if necessary.

NCLEX-RN Preparation

Preparation for the NCLEX-RN, the licensing exam for registered nurses in the United States, requires a strong grasp of clinical presentations, including the recognition of symptoms related to deficiencies of fat-soluble vitamins. Test-takers should be familiar with the consequences of long-term conditions such as cholethiasis, which can lead to such deficiencies, and learn how to interpret related clinical manifestations.

To study effectively, future nurses should focus on the application of knowledge through practice questions and by reviewing case studies that illustrate how vitamin deficiencies can present in patient scenarios. Exploring various study resources, such as textbooks, review courses, and online educational platforms, can reinforce their understanding and increase their chances of passing the NCLEX-RN.