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LABORATORY TESTS THAT REFLECT NUTRITION There are numerous biochemical tests that have nutritional implications. These are a few of the laboratory tests that can be utilized by nurses and dietitians to assess a patient’s nutritional status. Remember, however, that all of these tests provide a wide variety of information related to a multitude of disorders or disease processes and the nutritional implications are only a small part of their overall importance in diagnosing and assessing a patient’s condition. LABORATORY TEST Hemoglobin NORMAL VALUES 12-16 NUTRIENTS INDICATED Iron Serum Albumin 3.8-5.6 Protein Fluids Pre Albumin 10-40 Protein Serum Transferrin 240-480 Iron and Protein Total Protein 6-8.6 Protein Total Lymphocyte Count Schilling Test (24hr urine test) Sodium 0.66-4.6 or 20-40% of total WBC Excretion of 7% or > 135-145 Protein Potassium 3.5-5.3 K Calcium 8.6-10 mg/dl 2.15-2.50 mmol/L PT -11.0-13.0 seconds INR - 2.0-2.5 65-110 Calcium Protein CHO = more CHO intake than body can metabolize 5.5%-8.5% CHO 140-199 Cholesterol Fats 40-160 >90% Fats Protein Reflects blood glucose levels for past 120 days. For diabetics 7.5%-15%= good to moderate control; >15% = poor control = fat & Cholesterol intake too high Chol/HDL ratio very important - <3.25 desirable, >12 = high risk for atherosclerosis. Values are age and gender related. = fat intake high 70% = severe protein deficiency Zero balance Amino Acids Prothrombin Time Or INR Fasting Blood Glucose Glycosylated Hemoglobin (HbA1c) Cholesterol Triglycerides Creatinine Height Index Nitrogen balance Others: 10.3.11mas Intrinsic Factor Vitamin B12 Na, fluids Vitamin K Also Vitamin A POSSIBLE NUTRITIONAL IMPLICATIONS = anemia of some kind. Often suggests iron supplements, also folic acid. An important indicator, but RBCs and Hct must also be taken into account. = protein deficiency 21 days ago. Directly affected by fluid balance. Not used by dietitians for acute assessment. = protein deficiency within 2-day time period. Used by dietitians for acute assessment of nutritional status. = iron deficiency = protein deficiency Infrequently used by dietary and nursing = protein deficiency Not used often by dietitian consulted. = protein deficiency, but no good information found in lab books r/t nutrition or from dietitian consulted. = lack of intrinsic factor or inadequate intake of B12 = dehydration, excess salt intake, need for fluids = fluid excess = inadequate intake of K, may indicate need for supplements especially if patient is on diuretic therapy. = albumin deficiency (50% of blood Ca is protein bound), or calcium deficiency. Results affected by fluid balance. = Vitamin K deficiency or Hypervitaminosis A Negative balance means more excretion of nitrogen than is consumed = Malnutrition or severe trauma