After 24 hours, A.G.'s symptoms are unrelieved. she reports continued nausea, cramps, and sometimesstrong abdominal pain; her hand grips are weaker; and she seems to be increasingly lethargic

Question

You look up her latest laboratory values and compare them with the admission data.
Which laboratory values are of concern to you?
Why?

Answer 1

• The electrolyte of greatest concern is the potassium (K) level. A.G. is likely losing K through her NGT
drainage. K of 2.5 mEq/L is life-threatening, and A.G. is at risk for developing cardiac dysrhythmias.
• The protein and albumin levels are low and indicate progressive malnutrition or poor liver
function. Without them, A.G.'s colloidal oncotic pressure is decreased, and fluids leak from the
cardiovascular space to the interstitial spaces. Mobilization of fluids out of the cardiovascular
space can result in hypotension and shock; proteins are essential for healing.
• The BUN and creatinine are elevated. This increase could indicate acute renal failure, dehydration,
or increased protein catabolism as a result of malnutrition. Because A.G. has not been started on
parenteral nutrition, her body could be catabolizing protein for energy.
• The Na, Cl, and glucose are decreased. A.G. could be losing Na and Cl through the NGT drainage,
resulting in metabolic alkalosis. Glucose could be decreased because of starvation; she is not
taking in the daily calories required for energy production.