& x20; A patient with prolonged protein deficiency will manifest with low plasma proteins which will affect t… - RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

Biochemistry & Nutrition

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

Explanation

Plasma proteins, with albumin being the most significant contributor (about 80%), are responsible for creating colloid osmotic pressure (or oncotic pressure) within the blood vessels.
This pressure acts like a 'water magnet,' holding fluid inside the circulatory system and preventing it from leaking into the surrounding tissues.
Prolonged protein deficiency leads to decreased synthesis of albumin by the liver, resulting in low plasma protein levels (hypoalbuminemia).
This directly reduces the colloid osmotic pressure, impairing the body's ability to maintain fluid balance between the intravascular and interstitial spaces.

Option B: Changes in blood pressure are a secondary consequence, not the primary effect. While a significant loss of fluid from the circulation can eventually lead to a drop in blood volume and, subsequently, blood pressure, the initial and direct failure is in maintaining osmotic pressure.
Option C: A decrease in circulatory blood volume is a result of the primary problem, which is the fall in osmotic pressure. The body fails to maintain blood volume because it can no longer maintain the osmotic pressure needed to hold fluid in the vessels.
Option D: Similar to circulatory blood volume, total blood volume is affected as a consequence of the fluid shift caused by low osmotic pressure. It is not the parameter that plasma proteins directly maintain.

Clinical Relevance

Nursing practice connection: Use the key finding related to Role of plasma proteins in maintaining colloid osmotic pressure to guide bedside assessment, documentation, and the next nursing action.
Nurses must assess patients at risk for protein deficiency (e.g., those with malnutrition, liver failure, or severe burns) for signs of edema, such as swelling in the ankles, legs (pitting edema), and abdomen (ascites). This is a key clinical sign of low colloid osmotic pressure.
Monitoring serum albumin levels is a critical nursing responsibility for these patients, as it helps in evaluating nutritional status and the risk of complications like edema and poor wound healing.
What if? If the patient had nephrotic syndrome (a kidney disease) instead of nutritional protein deficiency, the end result would be the same (edema due to low osmotic pressure), but the cause would be massive loss of albumin through the urine rather than decreased production.

How to Approach the Question

Identify the core physiological concept in the question: the function of plasma proteins in a state of deficiency.
Recall the main types and functions of plasma proteins. The most abundant is albumin.
Focus on the primary role of albumin, which is to generate colloid osmotic pressure to keep fluid within the blood vessels.
Connect the pathology (protein deficiency) to the function. A lack of protein leads to a lack of albumin, which directly causes a fall in osmotic pressure.
Differentiate between the primary, direct effect (loss of osmotic pressure maintenance) and the secondary consequences (changes in blood volume and blood pressure) to select the most accurate answer.

Concept Tested & Keywords

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E6 Physiology Guyton 4SAE Part 1 p. 168-170