During nutritional assessment, bleeding gums and gingivitis indicate a deficiency of which vitamin?

NHM UP Staff Nurse-2023 Shift-2nd

Applied Nutrition & Dietetics

Easy

Appeared in: NHM UP Staff Nurse-2023 Shift-2nd

Explanation

Bleeding gums and gingivitis are classic clinical manifestations of scurvy, the disease caused by severe Vitamin C deficiency.
Vitamin C is essential for the synthesis of collagen, a structural protein vital for maintaining the health and integrity of connective tissues, including the gums and capillary walls.
Without adequate Vitamin C, collagen production is impaired, leading to weakened capillaries that rupture easily, resulting in bleeding gums.
Other signs of Vitamin C deficiency include poor wound healing, petechiae (small skin hemorrhages), and easy bruising, all related to fragile connective tissue and blood vessels.

Option A: Vitamin D deficiency primarily affects bone health by impairing calcium absorption.
Option C: Vitamin A deficiency is classically associated with vision problems and impaired immune function.
Option D: While some B vitamin deficiencies cause oral symptoms (like cheilosis or glossitis), bleeding gums is not the characteristic sign. 'Vitamin B' is also a broad category.

Clinical Relevance

Nursing practice connection: Use the key finding related to Nutritional assessment and signs of vitamin deficiencies to guide bedside assessment, documentation, and the next nursing action.
Nurses play a key role in nutritional screening. Observing signs like bleeding gums during patient assessment can be an early indicator of malnutrition, prompting further investigation and dietary intervention.
Patient education is crucial. Nurses should teach patients at risk about dietary sources of Vitamin C, such as citrus fruits (oranges, lemons), amla (Indian gooseberry), guava, broccoli, and bell peppers.
What if? If the patient with bleeding gums also had cracks at the corners of their mouth (angular cheilitis) and a swollen, magenta tongue (glossitis), the nurse should suspect a concurrent Vitamin B2 (riboflavin) deficiency, as multiple nutritional deficits can coexist.

How to Approach the Question

First, identify the key clinical signs presented in the question: 'bleeding gums' and 'gingivitis'.
Recall the major functions and deficiency syndromes associated with each vitamin listed in the options.
Systematically evaluate each option. Ask yourself, 'What is the classic sign of Vitamin D deficiency?' (Rickets/osteomalacia). 'Vitamin A?' (Night blindness). 'Vitamin B?' (Varies, but not primarily bleeding gums).
Match the clinical signs from the question to the corresponding vitamin deficiency. Bleeding gums is a hallmark symptom of scurvy, which is caused by Vitamin C deficiency.
Select the option that directly aligns with the presented symptoms.

Concept Tested & Keywords

Concept Tested: Nutritional assessment and signs of vitamin deficiencies
Stem keywords: nutritional assessment, bleeding gums, gingivitis, vitamin deficiency
Lead-in keywords: indicate a deficiency of which vitamin
Negative lead-in flag: false

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E6 textbook of Applied Biochemistry and Nutrition & DieteticsHarbans Lal (pp 26-464 of 479) p. 370-372

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E6 Medicine Harrison 22e Part 2 p. 507-509