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Please provide feedback to the Bold responses to the two case study questions below. 

– Do you agree or disagree with the answer? Why or Why not?

– Do you have another perspective on how the question should be answered? 

– Can you provide a reference for your explanation by summarizing an article related to the topic?

– Have you had a personal experience assisting a patient similar to the case study question below?

 

Mr. Jensen has had a long recovery time after having a ruptured abdominal aortic aneurysm (AAA).  He has been in the hospital for 4 weeks now after surgery.  You have just assumed care of the patient and while awaiting report, look up the patient’s lab values.  Labs show:

Total Protein- 5.0 gm/dl (normal 6-8.3)

Albumin- 2.6 gm/dl (normal 3.4-5.4)

 

Why might these lab values be low? 

The reason that the protein and albumin levels might be low is because there’s inflammation from the ruptured abdominal aortic aneurysm and from the surgery. The protein is being broken down by the inflammatory cytokines, The body starts to breakdown the other proteins when the albumin isn’t being produced properly. . This would cause the low levels of the albumin and protein.When the albumin isn’t being produced properly it causes a reduction of protein in the blood, the plasma is diluted by the bodily fluids and there’s in an increased loss of protein. There could also be liver and kidney issues. The fluid being leaked out into the interstitial fluid, Also, the paitient may not have enough dietary protein intake to form enough albumin. https://a2zhealthy.com/albumin-test/2/

 

You get report from the night shift and go in to assess your patient.  His weight is up 12 lbs since surgery and his blood pressure is trending around 98/56. The patient has just begun ambulating in the hall requiring a lot of assistance and encouragement.  The patient has been advanced to a general diet but only eats 25% of each meal.  The patient complains of stiff joints and feeling “tight”.  He has 2+ pitting edema in dependent limbs.       

 

Why does this patient have edema?  What type of fluid shift is occurring?

This patient has edema r/t low total protein and albumin levels (low oncotic pressure) due to his recent AAA rupture/surgery. This is shifting fluids from the intravascular space to the interstitial space due to the hydrostatic (pushing) pressure being higher than the osmotic/oncotic (pulling) pressure causing a drop in BP.

SCIENCE
HEALTH SCIENCE
NURSING
NURSING MISC

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