Sutures and Wound Repair/ General Surgery (ABSA) Practice Test

Postoperative patients may experience negative nitrogen balance due to which factor?

1. Excessive hydration

2. Protein depletion

3. High carbohydrate intake

4. Low caloric intake

The correct answer is: Protein depletion

A negative nitrogen balance indicates that the body is losing more nitrogen than it is taking in, which often reflects a state of protein deficit. In postoperative patients, this can occur for several reasons, with protein depletion being a significant factor. During surgery and the postoperative period, the body requires adequate amounts of protein for tissue healing and repair, immune function, and maintenance of muscle mass. If the patient's protein intake is insufficient, either due to inadequate dietary intake or increased catabolism of body proteins due to stress from the surgical procedure, it can result in a negative nitrogen balance. While excessive hydration, high carbohydrate intake, or low caloric intake may contribute to various metabolic imbalances, they do not directly lead to a negative nitrogen balance in the same way that protein depletion does. Without adequate protein, the body begins to break down muscle and other proteins, leading to an overall loss of nitrogen as amino acids are released into the bloodstream and eventually excreted. This underscores the importance of monitoring and ensuring sufficient protein intake in the postoperative care of patients to maintain a positive nitrogen balance and promote healing.