Nutrition, part 4: Fat Soluble Vitamins - Vitamins A, D, E, K

by Cathy Parkes July 16, 2021 Updated: January 25, 2022 8 min read

Welcome to our overview on fat-soluble vitamins (Vitamin A, D, E, & K). This series follows along with our Nutrition Essentials for Nursing Flashcards which are intended to help RN and PN nursing students study for nursing school exams, including the ATI, HESI, and NCLEX.

Nutrition plays a key role in patient wellness, and patient teaching regarding nutrition is a key part of EVERY nurse’s job. These flashcards will help you understand the basics of nutrition, along with key nutritional and lifestyle considerations for common health disorders.

Cool Chicken When you see this Cool Chicken, that indicates one of Cathy's silly mnemonics to help you remember. The Cool Chicken hints in these articles are just a taste of what's available across our Level Up RN Flashcards for nursing students!

Vitamin A

Vitamin A plays a number of important functions in the body, like supporting vision, immune function, and cell growth.

Vitamin A sources

You can find vitamin A in a variety of food sources, including orange and yellow vegetables and fruits.

Carrots are the orange vegetable that everyone seems to know has vitamin A! And it's true. Carrots are orange and they are rich in vitamin A, and they do support vision.

Other orange or yellow vegetables or fruits include sweet potatoes, cantaloupe and mango—all rich in vitamin A as well.

You can also find vitamin A in fish, liver, dairy, and eggs.

Vitamin A deficiency

If your patient has a deficiency in vitamin A, it can cause a condition called xerophthalmia.

Xerophthalmia

Xerophthalmia is a condition of the eye that can cause night blindness, drying of the cornea, and drying of the conjunctiva.

Vitamin A toxicity

Vitamin A toxicity can cause an increase in intracranial pressure. It can cause nausea, headache, joint pain, coma, liver damage, and birth defects in a developing fetus.

Vitamin D

Vitamin D is critical for bone growth and remodeling because it increases calcium absorption, and it also helps to decrease inflammation in the body.

Vitamin D sources

A key source of vitamin D is the sunlight. If you have a patient who is inside all the time and doesn't get any sun, chances are they may be deficient in vitamin D and may require supplementation.

Other sources of vitamin D include food sources such as fatty fish, fish oil, and fortified foods. Often, milk or cereals are fortified with vitamin D, and that helps to increase an individual's intake of that vitamin.

Vitamin D deficiency

A vitamin D deficiency can result in rickets in children and osteomalacia in adults.

Rickets

Rickets is a disorder of bone loss due to vitamin D deficiency. Signs and symptoms of Rickets include decreased bone density, developmental delays, seizures, and skeletal deformity.

Studying rickets in nursing school or for the ATI, HESI, or NCLEX? Rickets is one of the key pediatric health alterations covered in our Pediatric Nursing Flashcards.

Osteomalacia

Osteomalacia is a disorder of bone loss due to vitamin D deficiency—the adult equivalent of rickets. Osteomalacia is also characterized by bone deformities as well as bone pain and seizures.

Cool Chicken Low Vitamin D can cause Decreased bone Density, bone Deformity.

Vitamin D toxicity

Toxicity associated with excess vitamin D is always a risk because it's a fat soluble vitamin and stored in the body for a long period of time.

Signs and symptoms of vitamin D toxicity can include hypercalcemia, nausea and vomiting, muscle weakness, and dehydration.

Vitamin E

Vitamin E plays a number of important functions in the body: it acts as an antioxidant, it helps to support immune function and it also supports metabolism.

Vitamin E sources

You can find vitamin E in foods such as seeds, nuts, vegetable oil, and green leafy vegetables.

Vitamin E deficiency

If you have a deficiency in vitamin E, this can cause peripheral neuropathy as well as ataxia, which is impaired balance and coordination.

A lack of vitamin E can also cause a decrease in immune function.

Vitamin E toxicity

Vitamin E toxicity can impair blood coagulation, which would increase a patient's risk for bleeding.

Cool Chicken Too much E = blEEding.

Vitamin K

Vitamin K is another fat-soluble vitamin that is important for blood clotting as well as bone maintenance.

Vitamin K sources

You can find vitamin K in a variety of foods including green leafy vegetables like broccoli, kale, and collard greens. You can also find it in vegetable oil and soybeans.

Vitamin K deficiency

A deficiency in vitamin K places someone at increased risk for bleeding, because vitamin K is an essential component of the coagulation cascade. If you don't have enough vitamin K, your blood won't clot effectively and you will have increased risk of bleeding.

Vitamin K toxicity

There's a lower potential for toxicity with vitamin K than with the other fat-soluble vitamins.

However, if you have a patient who is on warfarin, which is an anticoagulant that works by antagonizing vitamin K, then it's going to be important for that patient to maintain a consistent intake of vitamin K. If this patient suddenly increases their intake of vitamin K, the warfarin won't be as effective at its anticoagulation.

If they suddenly decrease their intake of vitamin K, then they will be at risk for bleeding.


Full Transcript

Hi, I am Cathy with Level Up RN. And in this video, I am going to go over the fat soluble vitamins, so vitamins A, D, E, and K.

And if you're following along with cards, I'm on card number 11. And if you stick with me through the whole video, at the end, I will give you guys a little quiz, little knowledge check, make sure you're paying attention.

Let's start with vitamin A. Vitamin A plays a number of important functions in the body including supporting vision as well as immune function and cell growth.

You can find vitamin A in a variety of food sources including orange and yellow vegetables and fruits.

So carrots is the one that everybody seems to know. And it's true. Carrots are orange and they are rich in vitamin A, and they do support vision.

Other orange or yellow vegetables or fruits include sweet potatoes and cantaloupe and mango. And those are all rich in vitamin A as well.

You can also find vitamin A in fish, liver, dairy, and eggs.

So if your patient has a deficiency in vitamin A, it can cause a condition called xerophthalmia. And this is a condition of the eye that can cause night blindness, drying of the cornea, and drying of the conjunctiva.

If your patient has toxicity, because again, vitamin A as well as D, E, and K are all fat soluble vitamins, so there is definitely a greater risk of toxicity.

Toxicity can cause an increase in intracranial pressure. It can cause joint pain, liver damage, and birth defects in a developing fetus.

Alright. Now let's talk about vitamin D.

Vitamin D is another fat soluble vitamin. It is essential for calcium absorption. It is critical for bone growth and remodeling, and it also helps to decrease inflammation in the body.

A key source of vitamin D is actually the sunlight. So if you have a patient who is inside all the time and doesn't get any sun, chances are they may be deficient in vitamin D and may require supplementation.

Other sources of vitamin D include food sources such as fatty fish, fish oil, and fortified foods.

So, often milk or cereals are fortified with vitamin D, and that helps to increase an individual's intake of that vitamin.

Deficiency can result in Ricketts in children. So signs and symptoms of this disorder include decreased bone density, developmental delays, seizures, and skeletal deformity.

Or we can end up with osteomalacia in adults which is also characterized by bone deformities as well as bone pain and seizures.

So our little Cool Chicken hint here on card 12 is hopefully helpful for you. Low vitamin D can cause decreased bone density and bone deformity. So we got all those Ds in there in that sentence to help you remember that lack of vitamin D is going to cause those bone deformities and decreased bone density.

If we have toxicity associated with excess vitamin D, which is always a risk because it's a fat soluble vitamin and stored in the body for a long period of time, signs and symptoms of toxicity can include hypercalcemia, nausea and vomiting, muscle weakness, and dehydration.

Alright. Next up we have vitamin E. Vitamin E plays a number of important functions in the body.

It acts as an antioxidant. It helps to support immune function and also supports metabolism.

You can find vitamin E in foods such as seeds, nuts, vegetable oil, and green leafy vegetables.

If you have a deficiency in vitamin E, this can cause peripheral neuropathy as well as ataxia, which is a fancy name for impaired balance and coordination.

Also a lack of vitamin E can cause a decrease in immune function.

If we have too much vitamin E, so toxicity of vitamin E, this can impair blood coagulation which would increase a patient's risk for bleeding.

So our little Cool Chicken hint here on this card is that too much E can cause bleeding. So hopefully that's helpful for you!

And next up, we got vitamin K. Vitamin K is important for blood clotting as well as bone maintenance.

You can find vitamin K in a variety of foods including green leafy vegetables like broccoli, kale, and collards. You can also find it in vegetable oil and soybeans.

A deficiency in vitamin K places an individual at increased risk for bleeding because vitamin K is an essential component of the coagulation cascade. So if you don't have enough vitamin K, then you're not going to clot effectively and you have increased risk of bleeding.

So there's a low potential for toxicity, so too much vitamin K.

However, if you have a patient who is on warfarin, which is an anticoagulant that works by antagonizing vitamin K, then it's going to be important for that patient to maintain a consistent intake of vitamin K. Because if they suddenly increase their intake of vitamin K, their medicine is not going to be as effective.

They're not going to get good anticoagulation from warfarin. And if they suddenly decrease their intake of vitamin K, then they're going to be at risk for bleeding.

So they really need to maintain a consistent intake, and that will allow their provider to get the right dosing down of warfarin so that they can have the anticoagulation without too much clotting and without too much bleeding.

The other thing I want to mention is that it's really easy to confuse vitamin K with potassium, which the symbol for that is K. So definitely watch out for that. Super common amongst nursing students to get those two things confused.

Alright. You guys ready for quiz time? I have three questions for you.

First question. Xerophthalmia is caused by a deficiency of what vitamin?

Alright. If you answered vitamin A, you got that right.

Second question. Which vitamin is essential for calcium absorption?

Vitamin D. So when people are needing a calcium supplement, they are often given vitamin D at the same time because that vitamin D is needed for calcium absorption.

Third question. If you have a patient who is on warfarin, an anticoagulant, should they increase their intake of vitamin K, decrease their intake of vitamin K, or maintain a consistent intake of vitamin K?

Alright. If you answered consistent intake, you are right.

So if you had trouble with any of those questions, definitely go back and review the video. Take a look at our cards.

You got this. So I'm here for you. We'll get through all this material together, and I know you'll do great. Take care!


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