In the March Practice Points column, we reviewed the importance of developing and implementing clinical order sets. In this column, we will examine a number of laboratory tests and values that can help the clinician accurately manage a patient with a pressure ulcer. The culmination of this work can be organized into a clinical order set.
Albumin is a protein that acts as a building block for cells and tissues. Because it is produced by the liver, albumin levels may be reduced in patients with liver disease. The albumin level is also diminished in patients with renal disease, malnutrition, severe burn wounds, and malabsorption syndromes. Adequate intake of protein and essential nutrients is necessary to ensure adequate production of albumin.
The albumin test is the basic screening tool for protein status and a gross indicator of nutritional status and fluid balance. Albumin has a half-life of 18 to 20 days, making it sensitive to long-term protein deficiencies. The lower the albumin level, the greater the risk of edema because albumin accounts for a large portion of the oncotic pressure of blood plasma.
The albumin value is directly related to the severity of the protein deficiency. The extent to which albumin is decreased can help predict the risk of pressure ulcer formation. Albumin levels less than 3.2 g/dL have been shown to correlate with increased morbidity and mortality in patients admitted to the critical care unit. Elevated levels can be found in patients with dehydration, vomiting, diarrhea, and multiple myeloma.
Read the rest of the article at Advances in Skin & Wound Care.
An excerpt from an article originally published in Advances in Skin & Wound Care, written by Cathy Thomas Hess, BSN, RN, CWOCN, VP and Chief Clinical Officer at Net Health