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?
Restlessness
Edema
Pallor
Confusion
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. High fat content does not directly cause refeeding syndrome; fat is less likely to trigger the electrolyte shifts seen in this condition.
B. Rapid reintroduction of carbohydrates in malnourished patients stimulates insulin release, which drives phosphate, potassium, and magnesium into cells, leading to potentially life-threatening electrolyte imbalances—the hallmark of refeeding syndrome.
C. Excess protein intake can strain kidney function but is not the primary cause of refeeding syndrome.
D. Vitamin deficiencies, such as thiamine, can worsen complications, but the immediate trigger is the rapid carbohydrate load.
Correct Answer is B
Explanation
Rationale:
A. Obtaining a dietary history is important but not the priority in an acute exacerbation.
B. Reviewing electrolyte values is the first action. Clients with acute ulcerative colitis are at risk for fluid and electrolyte imbalances due to diarrhea, making this a priority assessment to prevent complications.
C. Investigating emotional concerns is important for holistic care but is secondary to addressing physiologic needs.
D. Checking perianal skin integrity is necessary but comes after assessing critical physiologic risks like electrolyte imbalances.
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