Overview
- Along with total protein, its primary function is the maintenance of the colloidal osmotic pressure in the vascular and extravascular spaces.
- It is a source of nutrition and a part of the buffer system.
- It is a “negative” acute-phase reactant.
- It decreases in response to acute inflammatory infectious processes.
- It is used to evaluate nutritional status, albumin loss in acute illness, liver disease and renal disease with proteinuria, hemorrhage, burns, exudates or leaks in the GI tract.
Normal Values:
Children: 2.9 – 5.5 g/dL or 22 – 55 g/L
Adults: 3.5 – 4.8 g/dL or 35 – 38 g/L
Procedure:
- This is done by obtaining 5 mL of serum in a tube.
- Fasting is not necessary.
- Low levels are associated with edema. Assess patient for signs and symptoms.
Clinical Implications:
- Increased albumin:
- Not associated with any naturally occurring condition.
- The only cause is decreased plasma water such as in dehydration.
- Decreased albumin:
- acute and chronic inflammations and infections
- cirrhosis, liver disease, alcoholism
- nephrotic syndrome, renal disease
- Chron’s disease, colitis
- congenital analbuminemia
- burns, severe skin disease
- heart failure
- starvation, malnutrition, malabsorption, anorexia
- Cushing’s disease, thyrotoxicosis
Interfering Factors:
- Pregnancy (last trimester, owing to increased plasma volume)
- Oral birth control (estrogens)
- Prolonged bed rest
- IV fluids, rapid hydration, overhydration
Nursing Implications:
- Check the albumin level from the protein electrophoresis results. Many clinical problems are the result of a serum albumin deficit.
- Assess for peripheral edema in the lower extremities when the albumin level is decreased. Albumin is the major protein compound responsible for plasma colloid osmotic pressure. With a decreased albumin level, fluid seeps out of the blood vessels into the tissue spaces.
- Assess for urinary output. Renal and collagen (lupus) diseases occur with abnormal protein fractions. Urine output should be 25mL/h or 600mL/24 hours.
