Question

match each client statement to either understanding teaching or needs further teaching regarding discharge teaching for a client who had a gastrectomy for stomach cancer.
\i can add soy milk fortified with vitamin b₁₂ to my diet to decrease the risk of pernicious anemia.\
\i will need a monthly injection of vitamin b₁₂ for the rest of my life.\
\an oral supplement of vitamin b₁₂ taken on a daily basis can meet my b₁₂ needs.\

Explanation:

• For the statement “I can add soy milk fortified with vitamin B₁₂ to my diet to decrease the risk of pernicious anemia.”: After gastrectomy, the parietal cells (which secrete intrinsic factor needed for B₁₂ absorption) are often removed. Oral B₁₂ (even fortified foods) may not be well - absorbed without intrinsic factor. So this statement needs further teaching.
• For the statement “I will need a monthly injection of vitamin B₁₂ for the rest of my life.”: Since intrinsic factor is likely absent (after gastrectomy), parenteral (injection) B₁₂ is the standard treatment for life. This shows understanding.
• For the statement “An oral supplement of vitamin B₁₂ taken on a daily basis can meet my B₁₂ needs.”: Similar to the first statement, oral B₁₂ absorption is impaired due to lack of intrinsic factor. So this needs further teaching.

Answer:

• “I can add soy milk fortified with vitamin B₁₂ to my diet to decrease the risk of pernicious anemia.”: Further teaching
• “I will need a monthly injection of vitamin B₁₂ for the rest of my life.”: Understands
• “An oral supplement of vitamin B₁₂ taken on a daily basis can meet my B₁₂ needs.”: Further teaching