Question about albumin level and nutrition

[Lex_pedsRN]

If a postop cholecystectomy patient has a mildly low albumin level of 3.2 could their albumin level be an indication of readiness for enhanced nutrition? Pt is up and walking, passing gas, already had a stool, and are still on a clears diet. Pt has no other abnormal lab values, and only other abnormal findings are a knowledge deficit and pain, but that is managed effectively with demerol. Also, the pt. is not nauseated/vomiting, wants to eat solid foods and openly discussed with me her desire to eat healthier foods. I mainly want to know if the pt's slightly low albumin level could be tied to nutrition like my lab values book indicates? Thanks in advance. :)

[Esme12, ASN, BSN, RN]

Was this a laparoscopic cholecystectomy? Is there any other health issues? What is the medical history? Yes... you need protein to heal. That would be more delayed wound healing

I would say readiness for enhanced nutrition is fine.....that patient is passing stool for heavens sake how long have they been in the hospital? Advance that poor patients diet!

[classicdame, MSN, EdD]

in a hospital setting you could ask the dietician for advice. From what you have described the patient is not critically low and would benefit from eating, especially protein. Hope the MD has allowed diet to be advanced

[WoundedBird]

What's their pre-albumin level? Since PA is unaffected by hydration status and your pt is on a clear liquid diet, this might give you a more accurate picture of their nutritional status.

[nurseprnRN, BSN, RN]

The readiness for enhanced nutrition nursing diagnosis has nothing whatsoever to say about laboratory studies. Because you are probably not the only student to think that you can decide what's important to make a nursing diagnosis, I'd like to remind you that the NANDA-I 2012-2014 gives the only definitive list of what constitute defining characteristics for each and every one of them; these complete lists are probably not found in any secondary source on care planning.

For example, the defining characteristics for readiness for enhanced nutrition are:

Attitude toward drinking is congruent with health goals

Attitude toward eating is congruent with health goals

Consumes adequate fluid

Consumes adequate food

Eats regularly

Expresses knowledge of healthy fluid choices

Expresses knowledge of healthy food choices

Expresses willingness to enhance nutrition

Follows an appropriate standard for intake (e.g., ADA food pyramid)

Safe preparation of fluids

Safe preparation of food

Safe storage of fluids

Safe storage of food

And that's it. If it's not on that list, you cannot diagnose readiness for enhanced nutrition. It sounds as if your patient does have some of the defining characteristics, though, so you can list those in your "as evidenced by."

Now, if you are looking for someplace to use your knowledge of the importance of serum proteins in nutrition (and don't forget prealbumin), you can look at other diagnoses that have impaired nutritional status (low serum albumin counts for that) as a defining characteristic and see if any of them might apply to your patient. HINT: pages 437, 443, in your NANDA-I, available for $29 and free 2-day delivery from Amazon. Get it now and you'll have the answer by the time your work is due on Friday :)