Validate lab interpretations if possible

[finzzleft]

hi guys. i am working on a care plan, and i have some wonky lab values, and i'm not sure if i've gotten proper interpretations. a little background:

the client is a >70 male presenting with diverticulitis. he is now 8 days post-op for three attempted anastomoses (two were not airtight and the third was sucessful) and a temp ileostomy. full liquid diet. vs were normal, but he did have an elevated temp (ranged from 99.8 - 100.3). came in to the hospital with an elevated wbc (+/- 13k). on two antibiotics. also getting peri-cal @ 75 ml/hr.

here are the wonky labs: and the ones i am having issues with are the protein/albumin and bun. no s/sx of dehydration, medical hx does not show any renal impairment or chf, and i am stumped as to why the bun is elevated and the protein is decreased. i thought perhaps it was the iv tpn, but having looked at the nutrients included in the solution, it supposedly contains "enough" protein. not looking for a handout, but some guidance would be most appreciated. thanks so much for any help you may be able to provide.

rbc

3.53 (l)

likely postop anemia, due to a diminished erythropoietic response

wbc

15.5 (h)

elevated wbc indicative of an infection.

hct

32.4 (l)

likely postop anemia, due to a diminished erythropoietic response

hgb

13.5 (l)

10.7 (l)

likely postop anemia, due to a diminished erythropoietic response

bun

24 (h)

total protein

5.9 (l)

albumin

1.9 (l)

[kgh31386, BSN, MSN, RN]

Here's a hint...first tell me what BUN is and where it comes from. Also this is why they say that when looking at renal function, Creatinine is specific to the kidney while increased BUN can have multiple causes or body system relations.

[finzzleft]

BUN is blood urea nitrogen. Urea is produced when protein is broken down. With low protein and albumin levels, I assume that the BUN would be elevated. I just can't figure out why, unless it's related to his surgery and wound healing. It's the only explanation I could think of, but my Davis lab guide doesn't really give a lot of details beyond renal impairment and dehydration.

[Esme12, ASN, BSN, RN]

Blood loss and NPO are both fluid depleting = dehydration. The albumin is also low due to blood loss and poor nutritional status with NPO status and surgical stress. You were actually almost right at the answer...:)