A patient is suspected of having protein calorie malnutrition ...

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A patient is suspected of having protein calorie malnutrition (PCM) with a body mass index of less than 18. Which laboratory tests should the nurse expect to be prescribed for this patient?
 
  Select all that apply.
  1. serum albumin
  2. lymphocyte count
  3. serum electrolytes
  4. complete blood count (CBC)
  5. Urinalysis

Question 2

A patient desiring to begin a very-low-calorie diet (VLCD) for rapid weight reduction is concerned about the safety of the diet. What information should the nurse provide to the patient?
 
  1. VLCDs are not recommended for people over age 50.
  2. VLCDs result in significant losses of muscle mass in response to the protein restriction.
  3. VLCDs are safe for patients who have a lower body mass index and need to lose a small amount of weight rapidly.
  4. VLCDs are safest for middle-aged and senior patients.

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Answer to Question 1

Correct Answer: 1, 2, 3
In PCM, serum albumin and lymphocytes count are reduced. Serum electrolytes are measured and potassium levels are low in severe malnutrition. While a CBC and urinalysis are important measures, they are not necessarily useful in determining protein calorie malnutrition.

Answer to Question 2

Correct Answer: 1
Very-low-calorie diets (VLCDs) are indicated for patients having elevated body mass indexes greater than 30 kg/m2. VLCD may not be appropriate for use in people over age 50 due to normal loss of lean body mass and adverse effects such as fatigue, constipation, nausea, diarrhea, and gallstone formation. These diets are protein-sparing modified fasts (450 kcal/day) conducted under close medical supervision and result in rapid weight loss while maintaining lean body mass.

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