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An older adult patient who is malnourished presents to the emergency department with a serum albumin that is low with total protein that is also low. Which clinical manifestation should the nurse expect?

A.

Restlessness

B.

Edema

C.

Pallor

D.

Confusion

Answer and Explanation

The Correct Answer is B

Rationale:

A. Restlessness can occur with electrolyte imbalances or hypoxia, but it is not a hallmark of low albumin or protein malnutrition.

B. Low serum albumin and total protein decrease plasma oncotic pressure, allowing fluid to shift from the vascular space into interstitial tissues, leading to peripheral and sometimes generalized edema (anasarca).

C. Pallor is more indicative of anemia, which may coexist but is not a direct effect of hypoalbuminemia.

D. Confusion can result from electrolyte disturbances, hypoxia, or hepatic encephalopathy, but it is not a direct manifestation of low albumin.


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Related Questions

Correct Answer is C

Explanation

Rationale:

A. The tubing for TPN must be changed every 24 hr (not 48 hr) to reduce the risk of central line–associated bloodstream infection (CLABSI).

B. Lipid emulsions should not hang for more than 12 hr to prevent bacterial growth and infection.

C. A 1.2-micron filter is required for TPN that contains lipids to remove particulate matter, bacteria, and fungi, since lipid solutions cannot pass through smaller filters.

D. TPN solutions should be changed every 24 hr (not 36 hr) to reduce infection risk.

Correct Answer is C

Explanation

Rationale:

A. NG tube drainage usually leads to loss of gastric fluid, which is rich in hydrochloric acid and potassium, but sodium is not typically elevated.

B. Magnesium loss is minimal in gastric drainage; elevation is unlikely.

C. Gastric secretions contain large amounts of potassium, so prolonged NG suctioning can lead to hypokalemia, which increases the risk of muscle weakness, cardiac dysrhythmias, and fatigue.

D. Calcium loss is not a direct consequence of NG tube drainage.

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