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Chapter 24
Vitamins and Minerals
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Chapter 24
Lesson 24.1
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Learning Objectives
• Identify the actions and indications for
vitamins and minerals
• List at least six products used to treat
vitamin or mineral deficiencies
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Vitamins
• Natural chemical compounds found in
animals and plants
• Dietary considerations
• Deficiencies
• Antioxidants
• MyPyramid
• Table 24-1
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Vitamin A
Action
• Fat-soluble; aids visual adjustment; role in
cell membrane stabilization
Uses
• Treat deficiencies, eye diseases, and night
blindness
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Vitamin A (cont.)
Adverse Reactions
• Hypervitaminosis
Drug Interactions
• Oral contraceptives, mineral oil,
antihyperlipidemic drugs
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Vitamin A (cont.)
Nursing Implications
• Lifespan requirements
• Routes for administration
• Patient teaching: nutritional sources
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Vitamin B1 (Thiamine)
Action
• Water-soluble; coenzyme involved with
carbohydrate metabolism; role in neurology
Uses
• Treatment of beriberi
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Vitamin B1 (Thiamine)
(cont.)
Adverse Reactions
• Sensitivity reactions
• Parenteral precautions
Drug Interactions
• Poor stability with concurrent use of neutral or
alkaline solutions
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Vitamin B1 (Thiamine)
(cont.)
Nursing Implications and Patient Teaching
• Food preparation
• Dietary sources
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Vitamin B2 (Riboflavin)
Action
• Water-soluble; precursor of two essential
enzymes that deal with metabolism of fats,
proteins, and carbohydrates
• Related to the release of energy to cells
• Active in the respiratory system
Uses
• Deficiency
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Vitamin B2 (Riboflavin)
(cont.)
Drug Interactions
• Oral contraceptives
Nursing Implications and Patient Teaching
• Storage
• Change in urine color
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Niacin
Action
• Water-soluble; part of two coenzyme systems
that transfer hydrogen in intracellular
respiration
Uses
• Prevent or treat deficiencies
• Pellagra: symptoms
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Niacin (cont.)
Adverse Reactions
• Dry skin, pruritis, skin rash, GI disorders, allergies,
feelings of warmth, headache, tingling of the skin,
transient flushing in the face and neck
Drug Interactions
• Antihypertensives
Nursing Implications/Patient Teaching
• Dietary sources
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Pantothenic Acid
Action
• Synthesis of coenzyme A; role in release of
energy in fats, proteins, and carbohydrates
Uses
• Treatment of paralytic ileus
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Pantothenic Acid (cont.)
Nursing Implications and Patient Teaching
• Food preparation
• Dietary sources
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Vitamin B6
(Pyridoxine Hydrochloride)
Action
• Water-soluble; functions as coenzyme in
metabolism of protein, fats, and carbohydrates
Uses
• Treat deficiencies due to inborn errors of
metabolism, such as vitamin B6 dependency,
B6-responsive chronic anemia, and other rare
vitamin problems
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Vitamin B6 (cont.)
Adverse Reactions
• None; pyridoxine dependency
Drug Interactions
• Oral contraceptives; levodopa
• Concurrent use with chloramphenicol may
prevent optic neuritis
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Vitamin B6 (cont.)
Nursing Implications and Patient Teaching
• Storage
• Dietary sources
• Food preparation
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Folic Acid (Vitamin B9)
Action
• Water soluble; required for normal erythropoiesis and
nucleoprotein synthesis
• Metabolized in the liver and changed to an active form
Uses
• Treat anemias caused by folic acid deficiencies; treat
alcoholism, hepatic disease, hemolytic anemia;
supplemental during infancy (formula), lactation, oral
contraceptive use, and pregnancy
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Folic Acid (cont.)
Adverse Reactions
• Folic acid is not toxic
• Allergic reaction may manifest as
bronchospasm, erythema, malaise, pruritis, or
rash
Drug Interactions
• Antagonists: chloramphenicol and methotrexate
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Folic Acid (cont.)
Nursing Implications and Patient Teaching
• RDA
• Parenteral forms should be protected from light
• Patient and family teaching: nutritional
counseling; laboratory monitoring; need for
medical follow-up
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Vitamin B12
Action
• Water-soluble and contains cobalt; produced by
Streptomyces griseus; functions in fat, protein, and
carbohydrate metabolism; part of the erythrocyte-maturing
factor in the liver; required for DNA synthesis
Uses
• Treats all B12 deficiencies, pernicious anemia, other anemias,
malabsorption syndromes, blind loop syndrome, pregnancy,
chronic liver disease complicated by vitamin B12 deficiency,
malignancy, thyrotoxicosis, renal disorders
• Used in the flushing dose in Schilling test
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Vitamin C
Action
• Acts in several enzyme systems; involved in
intracellular oxidation-reduction potentials;
aids in the change of folic acid and the
metabolism of certain amino acids; aids in the
absorption of calcium and iron; blocks the
absorption of copper in the GI tract; protects
vitamins A and E and polyunsaturated fatty
acids; necessary for the formation of teeth,
connective tissue, and capillaries for the
synthesis of collagen; wound healing
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Vitamin D
Action and Uses
• Fat-soluble
• Three categories
• Movement of calcium and phosphorus ions into small intestine,
kidneys, and bone
• Used to treat childhood rickets, adult osteomalacia,
hypoparathyroidism, and familial hypophosphatemia
Adverse Reactions: Vitamin D toxicity
Nursing Implications and Patient Teaching
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Vitamin E
• Fat-soluble
• Functions are not understood
• Antioxidant: prevents cell membrane
damage
• Stabilizes the RBC wall to protect
against hemolysis or destruction
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Vitamin K
Action
• Fat soluble; helps hepatic formation of active
prothrombin proconvertin, plasma
thromboplastin component, and the Stuart
factor
Uses
• Treat or prevent blood-clotting disorders
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Chapter 24
Lesson 24.2
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Learning Objectives
• Identify the actions and uses for
minerals in the body
• List at least six supplements used to
treat mineral deficiencies
• Prepare a teaching plan for patients
who require mineral supplements
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Minerals
• 19 inorganic substances present in the
body; 13 are essential to normal
metabolism and function
• Ions: positive and negative charges
• Electrolytes
• Table 24-2
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Calcium
Action
• Essential for muscular and neurologic activity; formation
and repair of skeletal tissues; activates several enzymes
that influence cell membrane permeability and muscle
contraction; aids in blood clotting; activates pancreatic
lipase; influences intestinal absorption of cobalamin;
involved in the transmission of neurotransmitters and in
metabolic processes; regulation of lymphocyte and
phagocyte function through interaction with calmodulin
Uses
• Supplement when dietary levels are low
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Calcium (cont.)
Adverse Reactions
• Hypercalcemia symptoms
Drug Interactions
• Vitamin D; phytic acid (found in bran and
whole-grain cereals)
Nursing Implications/Patient Teaching
• Dietary sources
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Fluoride
Action
• Strengthens enamel
Uses
• Reduces dental caries
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Fluoride (cont.)
Adverse Reactions
• GI distress, urticaria, and malaise; excessive salivation,
mottling of teeth, GI disturbances, and nausea are seen
with overdosage
Drug Interactions
Nursing Implications and Patient Teaching
• Administration; avoid glass containers when diluting
fluoride; milk may decrease absorption
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Iron
Action
• An essential mineral for the synthesis of myoglobin and
hemoglobin; stimulates the hematopoietic system and
increases hemoglobin to correct iron deficiency
Uses
• Treatment of symptomatic iron deficiency; prevent
hypochromic anemia during infancy, childhood,
pregnancy, and breastfeeding from other anemias; after
some GI surgeries
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Iron (cont.)
Adverse Reactions
Drug Interactions
Nursing Implications and Patient Teaching
• Nutritional sources, adverse effects
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Magnesium
Action
• Maintains osmotic pressure, ion balance, bone structure, muscular
contraction, and nerve conduction
Uses
• Deficiencies
Adverse Reactions
• Diarrhea
Nursing Implications and Patient Teaching
• Cardiac monitoring
• Nutrition
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Manganese
Action
• Activates many enzymes, assists in normal skeletal
and connective tissue development, helps in the
initiation of protein synthesis, and plays a part in the
synthesis of cholesterol and fatty acids
Uses
• Dietary supplements for multiple deficiencies
• Natural sources of manganese
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Potassium
Action
• Principle intracellular cation of most body
tissues; active in maintaining normal renal
function, contraction of muscle, and
transmission of nerve impulses
Uses
• Prophylactic – nephrotic syndrome, hepatic
cirrhosis with ascites, hyperaldosteronism
• Replacement therapy
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Potassium (cont.)
Adverse Reactions
• Nausea, vomiting, diarrhea, abdominal discomfort, GI
bleeding
Drug Interactions
• Contraindications
Nursing Implications/Patient Teaching
• Dilution and administration; monitoring of serum blood
levels; dietary sources
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Zinc
Action and Uses
• Essential for normal growth and tissue repair, mineralization of bone,
detoxification, creation of DNA, synthesis of protein
• Prevent zinc deficiency and aid wound healing
Adverse Reactions
• GI, nausea and vomiting; excessive dosage; intoxication
Drug Interactions
• Calcium
Nursing Implications/Patient Teaching
• Dosing and nutrition
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Vitamin and Mineral Deficiencies
• Assessment
• Diagnosis
• Planning
• Implementation
• Evaluation
• Patient and family teaching
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