Which combination of nutritional laboratory abnormalities is most commonly seen after a major burn?

• A. High protein, high albumin
• B. Normal protein and normal albumin
• C. Elevated glucose only
• D. Low protein, low albumin, and low sodium

Answer: (D)

Major burn injuries trigger a strong stress response that drives rapid protein breakdown and loss from the wound and through capillary leak. This catabolic state lowers circulating proteins, so albumin decreases along with overall protein levels. At the same time, large volumes of IV fluids and ongoing losses from burned tissue lead to shifts in fluid and electrolytes, which commonly produce dilutional effects and sodium losses, resulting in low serum sodium in the acute phase. Put together, the typical nutritional laboratory picture after a major burn is low protein, low albumin, and low sodium. The other patterns don’t fit this picture: protein and albumin wouldn’t be high in such a catabolic state, and while glucose is often elevated due to stress, that alone doesn’t capture the key protein and electrolyte disturbances.