The nurse is planning care for a client with a low serum albumin level.
Which of the following interventions should the nurse include in the client’s plan of care?
The nurse is planning care for a client with a low serum albumin level.
Which of the following interventions should the nurse include in the client’s plan of care?
A. Obtain a capillary blood glucose
[10%]
B. Implement seizure precautions
[23%]
C. Implement strict bed rest
[16%]
D. Collaborate with a registered dietician
[51%]
Statistics
Subject/Lesson
Subject
Adult Health
Lesson
Urinary/Renal/Fluid and Electrolytes
Client Need
Test Plan
Physiological Adaptation
Related Topic
F&E Imbalances
Item Type
Item Type
Application
Explanation
Choice D is correct. Normal albumin levels are 3.5-5.0 g/dL, 34–50 g/L. Collaboration with a registered dietitian (RD) is recommended for numerous reasons. First, the registered dietician can perform a nutritional assessment. Second, following the nutritional assessment, the registered dietician can focus on increasing the protein intake necessary for healing. Third, the registered dietician can make recommendations regarding appropriate foods that may be integrated into the client's diet based on the client's personal preferences. Fourth, the registered dietician can perform client education and educate the client regarding the nutritional needs of the client and food sources of protein. Therefore, collaborating with a registered dietician will significantly benefit this client experiencing hypoalbuminemia and should be included in the client's care plan.
Choice A is incorrect. Capillary blood glucose monitoring is not required for a client with hypoalbuminemia.
Choice B is incorrect. Seizure precautions are not necessary for clients with hypoalbuminemia. This would be required if the client had severe hyponatremia (< 125 mEq/l, mmol/L).
Choice C is incorrect. Strict bed rest is not indicated for hypoalbuminemia clients.
Additional Info
✓ Albumin is a major serum protein that is below normal, often found in clients who have had inadequate nutrition for extended durations of time.
✓ Albumin synthesis takes place in the liver, after which it is excreted into the bloodstream.
✓ Low albumin values are associated with longer hospital stays.
✓ Hypoalbuminemia is the most common nutrition-related abnormality in clients with infection.
✓ Albumin plays a key role in fluid and electrolyte balance.
✓ For some clients, severe undernutrition results in decreased serum albumin and prealbumin, resulting in delayed healing and third spacing. One must treat the underlying cause of hypoalbuminemia.
✓ High albumin may indicate dehydration. Look for increased hemoglobin and/or hematocrit in such clients.
✓ Some causes of low albumin may include the use of intravenous fluids, rapid hydration, and overhydration; cirrhosis or other liver diseases (including chronic alcoholism); burns, nutritional deficiencies, or protein-losing enteropathies (including Crohn's disease and ulcerative colitis).
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