low albumin

Tish88 · Mar 17, 2009

One should not use IV albumin for nutritional reasons, it is very short acting and falsely increases albumin level in the blood. The best way to increase a renal patients albumin level is through the gut.

If the patient refuses to eat, maybe you should consider tubing feeding with Nepro or consider trying IDPN (Intradialytic parenteral nutrition). However, IDPN can cause liver function abnormalities over a long period of time.

Your best bet is to encourage the patient to eat protein rich foods.

Trauma Columnist · Mar 17, 2009

I think you have to realize that low albumin is a predictor of high mortality. If the pt is AAOx3 and simply "can't" eat, then I would consider uremia to be a factor: is the pt receiving adequate dialysis? If the pt wants to try to improve their albumin then tube feeding MIGHT be an option but almost always results in diarrhea which can be disturbing. Other things to consider would be depression, another co-morbidity such as CHF or COPD making eating difficult. If they are diabetic, is their hgbA1C in range?

morte, LPN, LVN · Mar 17, 2009

this may be a digestion issue, perhaps low stomache acid, perhaps lacking pancreatic enzymes. it wont make any difference how much goes in, if the body cant break it down and absorb it....

retiredlady · Mar 17, 2009

The patient has fluid in his abd that has to be drained every month. Gets albumin when it is drained.Possible liver problems. Just started to go downhill, hard to walk, weak. they are thinking of changing their dry weight. Would that help? Better dialysis? Not diabetic.

allnurses Guide · Mar 17, 2009

Almost all of my patients (end stage heart failure) have cardiac cachexia as well as renal insufficiency. Many have pre-albumins

Valerie Salva, BSN, RN · Mar 21, 2009

ESRD pts who also have liver failure are the hardest- their colloidal oncotic pressures are so low because high protein diet and admin of albumin are usually contraindicated in liver pts (due to resulting high ammonia levels and hepatic encephalopathy), but adequate albumin levels are needed to maintain colloidal pressures and keep the excess fluid in the vasculature so dialysis can remove it- not possible with liver pts.

They will have very low bps, and the lower half of their bodies are usually full of fluid that you can't touch w/ dialysis

You can't win w/ these pts. They usually don't last very long.

workingmomRN · Mar 28, 2009

If a patient has pancreatitis, receiving TPN & IV ATB's at home with a HHN, and having very little oral intake like small amounts of broth, what causes the patient to have constant diarrhea? I have seen alot of patients who are declining rapidly & have almost stopped eating, but have terrible diarrhea. Where is it coming from and can anything be done about it?

jnette, ASN, EMT-I · Mar 28, 2009

ESRD pts who also have liver failure are the hardest- their colloidal oncotic pressures are so low because high protein diet and admin of albumin are usually contraindicated in liver pts (due to resulting high ammonia levels and hepatic encephalopathy), but adequate albumin levels are needed to maintain colloidal pressures and keep the excess fluid in the vasculature so dialysis can remove it- not possible with liver pts.
They will have very low bps, and the lower half of their bodies are usually full of fluid that you can't touch w/ dialysis
You can't win w/ these pts. They usually don't last very long.

Couldn't agree more.. have had several of these.. very sad cases.

20major · May 14, 2009

? progressing to multiorgan failure (RRT + paracentesis),cachexic. TPN while on dialysis as nutritional support. Maintain comfort through dialysis and paracentesis

and ensure adequate pain control .

MKJ22 · Oct 1, 2009

If you have an albumin of 1.2 what is your thought. Questionable radiation colitis, edema continuing, 3rd spacing, taking blood. what do I need to look for?

retiredlady · Oct 1, 2009

kidney disease or failure, liver problems, malnutrition.