Nutritional

A low prealbumin can look like a nutrition problem while actually signalling inflammatory illness. The reverse is equally important: a patient can lose substantial muscle and body fat while prealbumin remains within the reference interval. Use these measures to answer different clinical questions. Prealbumin and albumin describe the effects of inflammation, hepatic synthesis, renal handling, and fluid distribution. They do not measure total body protein, skeletal muscle, or protein-energy malnutrition. Malnutrition is established from intake, weight trajectory, body-composition findings, physical examination, and function. Nitrogen balance estimates whether measured protein intake exceeds measured nitrogen losses, but only when the intake record and urine collection are reliable and major confounders are addressed. For Canadian acute care, the first step is systematic screening rather than opportunistic laboratory testing. The Canadian Nutrition Screening Tool and the Integrated Nutrition Pathway for Acute Care provide the nursing entry point; a positive screen leads to more comprehensive assessment. The result should then shape safe nutrition support, including assessment for refeeding risk before calories are substantially reintroduced.