Nutrition Care for Individuals and GroupsDifficulty 3/5
A malnourished patient who has eaten almost nothing for ten days is started on nutrition support. Which laboratory change signals refeeding syndrome?
- AA fall in serum phosphorus, potassium and magnesium within days of feeding
- BA rise in blood urea nitrogen reflecting increased protein catabolism
- CA fall in serum albumin as the acute-phase response intensifies
- DA rise in serum sodium as fluid shifts into the intracellular space
Show answer and rationale
Correct: A. Reintroducing carbohydrate drives insulin release, pushing phosphate, potassium and magnesium intracellularly. Falling levels of those three electrolytes in the first days of feeding is the defining picture, and feeding must be advanced slowly with replacement and thiamine.
- D — Sodium shifts are not the defining marker of refeeding syndrome.
- B — Rising urea reflects protein load or renal function, not refeeding.
- C — Albumin is a negative acute-phase reactant and a poor nutrition marker.