 Welcome to nursing school explainer this video on folate deficiency anemia. So first of all folate or folic acid is vitamin B9 and is in charge or helps us with synthesis of DNA heme formation which is on the portion the iron portion of the hemoglobin on the red blood cell and Then it also is important for neurotransmitter formation And that is specifically in utero. It helps with the neural tube Development and that is important as we continue on in this video So risk factors for developing folate deficiency is When there is decreased absorption due to some sort of GI surgery So think about patients maybe with a gastric bypass a gastric sleeve And also those that have had a whipple procedure for some pancreatic issues Certain medications put the patient at risk for folate deficiency Which are birth control pills as well as metformin and then certain chemotherapy agents Patients with chronic alcohol abuse are also at risk for folate deficiency and those with malnutrition So don't only think about patients maybe that live in Circumstances where they don't get good nutrition, but also those with eating disorders for example, so anorexia or bulimia come to mind here Signs and symptoms as with any anemias the patient will have some sort of Pallor appear more pale. They might be fatigued and dizzy in Response of the anemia so the red blood cell can't going down They might exhibit symptoms of fluid volume deficits such as increased heart rate Increased respiratory rate as the body is trying to draw in more oxygen to help with to compensate for the anemia They might be at risk for bleeding because of low platelet formation There might be mood changes and memory difficulty and then glossitis, which is a red beefy swollen tongue that is actually Almost a tell-tale and sign for many different anemias and also for folate deficiency And then in utero like I mentioned before it can lead to neural tube defects And those specifically are spina bifida and and cephaly cleft lip and cleft palate as well as spasticity of the extremities For diagnostic tests on a CBC we're going to have anemia So low red blood cell count and low hemoglobin and hematocytes and then on the red blood cell indices The MCV the mean corpuscular volume will be Elevated meaning that these blood cells these red blood cells that are folate deficient are larger in size And that's also referred to as megaloblastic or macrocytics or bigger cells Certainly we want to check the patient's folate level and that is best done when the patient is fasting Fasting and then we also want to check their B12 MMA and homocysteine levels which are Also because B12 deficiency is another anemia that the patient can have and B12 is the only other anemia that is also megaloblastic Meaning that the cells are big so in order to distinguish between folate deficiency and B12 Deficiency we're going to have to run both tests folate as well as B12 with the other associated tests And I have a separate video about B12 deficiency. You can learn a little bit more about that as for Treatment so we want to increase the PO intake if the patient is folate deficient PO supplementation might be needed and we specifically want to advocate For pregnant or women that are planning to become pregnant to take at least 400 micrograms of folate per day and that is best done in a supplementation to make sure they get this Specific minimum dose to prevent these neural tube defects in utero And then we also want to supplement for patients that are on Medications such as over here chemotherapy or your diabetics on metformin And also those that have decreased absorption because of some sort of GI issue in severe cases We can also replace the folate. I am When the patient either doesn't tolerate it or maybe has trouble with with compliance those those things When B12 deficiency becomes really severe complications include confusion and or disorientation Orientation but these actually improve with treatment. So if we supply the patient enough folate Actually, these symptoms will go away Unlike in B12 deficiency anemia if the patient develops some neurologic symptoms, they might be permanent and irreversible so keep that in mind in distinguishing B12 and folate deficiency and then certainly another complication are those neural tube defects in in utero that we already discussed For our nursing considerations, we want to make sure we identify patients at risk So specifically those are pregnant or planning to become pregnant the chemotherapy patients patients with GI surgery and on metformin people Patients that have chronic alcohol malnutrition issues and then we want to educate them about signs and symptoms of developing So that they might advocate for themselves and then request some labs We certainly want to advocate for women of childbearing age if they think about or are not preventing pregnancy consciously to Recommend taking that supplement just in case they become pregnant so that We prevent the neural tube defects and then we want to educate our patients about dietary sources and dietary sources of folate a whole grains dark green leafy vegetables Which are a source of a lot of good nutrients? So that's always a good answer Avocado peanuts meat and fish and then orange juice a good dietary resources So there's a lot of good options here to recommend to our patient So thank you for watching this video on folate deficiency B9 deficiency Also watch my other video about the other types of the anemia B12 and specific because it's very similar to folate deficiency And also the one on iron deficiency, which is one of the common or the most common anemia. Thanks for watching nursing school Explained see you soon