A patient, who is hemodynamically stable, has been receiving protein replacement therapy for several days
The nurse realizes that which of the following laboratory tests would be the best to determine the patient's nutritional status at this time? 1. albumin
2. vitamin assay
3. transferrin
4. total lymphocyte count
3
Rationale: Transferrin is a plasma protein that binds with and transports iron to cells and may be more useful than albumin for tracking responses to nutritional therapies because its half-life is 8 to 10 days. Use of transferrin as an indicator of adequacy of nutrition in the high acuity patient may be limited because of other blood-related factors, such as blood loss anemia or blood transfusions, however the patient is hemodynamically stable and therefore transferrin is the best way to determine the patient's nutritional status at this time. Albumin should not be used as an indicator to detect early malnutrition or effectiveness of nutrition support. Vitamin assays should be assessed if the patient has a digestive or absorptive disorder. Total lymphocyte count should be interpreted with caution in the high acuity patient experiencing hypermetabolism or infections.
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