Which patient is least likely to develop negative nitrogen balance? The patient who
a. has severe burns
b. had an appendectomy
c. has a high fever
d. is confined to bed due to severe rheumatoid arthritis
B
Nitrogen balance measures protein equilibrium and is used to evaluate the patient's nutritional status. Patients on bedrest or with a fever are in a catabolic state that produces a negative nitrogen balance. The muscle wasting that occurs with immobility causes negative nitrogen balance. Massive trauma and burns are other common examples of catabolic states that produce a negative nitrogen balance.
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