Guest guest Posted April 22, 2011 Report Share Posted April 22, 2011 > I am in need of RD clinical judgement ammunition as to communicate effectively w an MD R/E interpreting prealbumin levels. > I am monitoring a SNF resident w IV sacral. Fro 1/11 to 3/11, wt increased (desired), wound healing, eating well, family aware of importance of protein, adequate kcals, fluids for wound healing support. Diet: NAS, arginaid, MVI, Vit C, ZNSO4, Procel 1 scoop TID (15 gm pro). March labs: all WNL chem 7, alb and prealbumin. > In April, new labs freaked out the MD: ESR sed rate 95, normal range 0-30, C reactive pro 142.8 normal range 0.0-1.0. prealbumin 16, now < NL. > MD wants more pro. I communicated that the prealbumin is not a tool for diagnosing adequacy of protein intake, and that the drop in prealbumin is likely related to the inflamation response evident by the elevated C reactive pro. > He wrote.... > " There was concern regarding markly elevated CRP. With the overall improved appearance and reduction in size of the ulcer do not believe the elevated CRP is related to inflammatory process of the ulcer and the elevated CRP maybe due to other inflammatory processes as the patient is experiencing inflammation in both knees. The elevated CRP could also be erroneous as there is no concomitant and elevation of the ESR. (actually, the ESR is >NL). " Protein supplement ProCel is not high protein (5 gm/scoop). Increase procel 2 scoops 4 x day (40 gm pro), in addition to Arginaid and repeat prealbumin in 5-7 days to determine response. " > Ugh. > I need a reference in hand prior to calling this doctor to discuss. > What script would you use, knowing I will likely have 60 seconds of his time. > Thanks for your help. O MS,RD,LD Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.