Laboratory Data in nutrition assessment

Ada pocket guide to nutrition assessment 2004

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Unformatted text preview: erum Serum sodium sodium Typically ↑ ly can be can normal or ↓ ↓ normal Serum sodium generally , normal Serum or ↑ reflects fluid status and not sodium balance sodium Adapted from Charney and Malone. ADA Pocket Guide to Nutrition Assessment, 2004. Laboratory Values and Hydration Status Lab Test normal Hypovolemia Hypervolemia Serum Serum osmolality osmolality (285-295 (285-295 mosm/kg) mosm/kg) Typically ↑ Typically but can be normal or ↓ Typically ↓ but can be normal or ↑ ↑ Urine sp. Urine Gravity Gravity 1.003-1.030 ↓ ↑ ↓ Other factors influencing Other result result Urine osmolality (200-1200 mosm/kg) mosm/kg) Low: diuresis, hyponatremia, sickle cell anemia anemia High: SIADH, azotemia, High: Adapted from Charney and Malone. ADA Pocket Guide to Nutrition Assessment, 2004. Laboratory Values and Hydration Status Lab Test Hypovolemia Hyper- Other factors influencing Other volemia result result Serum Serum albumin albumin ↑ ↓ Serum Serum sodium sodium Typically Typically ↑can be can normal or ↓ ↓, normal or ↑ Low: malnutrition; acute Low: phase response, liver failure failure High: rare except in High: hemoconcentration hemoconcentration Adapted from Charney and Malone. ADA Pocket Guide to Nutrition Assessment, 2004. Hypokalemia (K+< 3.5 mEq/L) • • • • • ↑ renal losses (diuresis) renal ↑ GI losses (diarrhea, vomiting, fistula) GI K+ wasting meds (thiazide and loop K+ diuretics, etc) diuretics, Shift into cells (anabolism, refeeding, Shift correction of glucosuria or DKA) correction Inadequate intake Hyperkalemia (K+>5.0 mEq/L) • • • Decreased renal excretion as in acute or Decreased chronic renal failure chronic Medications, e.g. potassium sparing Medications, diuretics, beta blockers, ACE inhibitors diuretics, Shift out of cells (acidosis, tissue necrosis, Shift GI hemorrhage, hemolysis) GI Serum Calcium • • • • Normal serum 9.0-10.5 mg/dL (includes Normal ionized calcium and calcium bound to protein, primarily albumin, and ions) protein, Io...
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