1. Shelbie Lockhart Clinic Presentation Summer 2016
Vitamin B12 Deficiency
Shelbie Lockhart
Clinic Presentation
Summer 2016

2. Client (Rita) Information
15 year old female
Severe Stuttering
Cognitive Deficits: sequencing events, following complex directions, problem solving etc.
Incontinent
Wheelchair bound
Depression (upon admit)
Memory Loss
3 years prior she was walking, running, and speaking typically
Some questions about cognition level prior to hospital admit

3. What is B12
A vitamin that aids in keeping nerves and blood cells healthy and helps to make DNA.
A lack of this can cause people to become tired and weak.
Deficiencies are slowly progressing; symptoms may take years to affect people
Diagnosed through blood test or bone marrow biopsy

4. Causes Thinning of stomach lining Pernicious Anemia
Surgery removing part of stomach or small intestine
Chron’s Disease, Celiac Disease, Bacterial Growth, Parasite
Heavy Drinking
Immune System Disorders (lupus)
Long-term use of acid reducing drugs
Insufficient Diet
Pernicious Anemia: makes it hard for body to absorb b12
Stomach acids help break down b12
Diet: vegetarians and vegans must be sure to supplement foods to get enough b12 – Grandmother reported that Rita does not each much meat
Deficiencies are slowly progressing; symptoms may take years to affect people

5. Symptoms Weakness, tiredness, or lightheadedness Shortness of breath
Pale skin
Smooth tongue
Constipation, diarrhea, loss of appetite
Numbness or tingling
Problems walking
Mental problems
Mental Problems: depression, memory loss, behavioral changes
Rita: presented with diarrhea, loss of appetite, inability to walk, tired, and cold

6. Treatment B12 injections Diet Change Multivitamin containing B12
**Any nerve damage caused by deficiency could be permanent

7. What about Rita? Medical: Speech Therapy: Receiving B12 injections
Hopeful that feeling will return to legs
Speech Therapy:
Sequenced Daily Tasks
Working Memory Activities
Problem Solving
Fluency Techniques
Will receive outpatient therapy to address stuttering and cognitive deficits
When we first started seeing her she was shut off and quiet…depressed
She was discharged a july 8th and was happy and initiating conversation

8. References
Vitamin B12. (2013, November 1). Retrieved July 15, Nazario, B., MD (Ed.). (2015, July 23). Vitamin B12 Deficiency. Retrieved July 7, New Orleans Children’s Hospital Inpatient Clinic Staffing. Summer 2016