Question

The nurse is caring for an anorexic client who is severely malnourished. A nasogastric feeding tube is inserted, and tube feedings are started. Which laboratory finding is the best indication that the client's nutritional status is improving?

A. Creatinine has dropped from 1.9 to 0.5 mg/dL.
B. Blood urea nitrogen (BUN) level has dropped from 15 to 11 mg/dL.
C. Prealbumin level has risen from 9 to 13 mg/dL.
D. Sodium has risen from 130 to 144 mg/dL.

Answer 1

A rise in the prealbumin level from 9 to 13 mg/dL is the best laboratory finding to indicate that a severely malnourished client's nutritional status is improving, as it reflects recent changes in protein synthesis and nutritional intake.

Step-by-step explanation:

The best indicator of an improving nutritional status in the context of malnutrition is the prealbumin level. Prealbumin is a protein made by the liver and is a marker for nutritional evaluation because it has a shorter half-life than albumin, thus reflecting recent changes in protein synthesis and nutritional intake. A rise in the prealbumin level indicates an improvement in the patient's protein stores and nutritional status. Hence, the lab finding showing that prealbumin level has risen from 9 to 13 mg/dL (Option C) is the best indication that the patient's nutritional status is improving.

In comparison, creatinine and BUN levels are more reflective of renal function than nutritional status. Decreased creatinine might indicate an improvement in renal function or a decrease in muscle mass, and a moderate change in BUN may also be a result of hydration status rather than nutrition. While sodium levels can show improvements in electrolyte balance, they do not directly indicate nutritional status.