For which client would the nurse anticipate a decreased serum albumin level?

A decreased serum albumin level is most commonly associated with liver disease, particularly severe liver disease. Albumin is a protein produced by the liver, and in conditions where liver function is compromised, such as cirrhosis or severe hepatitis, the liver's ability to synthesize albumin diminishes significantly. As a result, this leads to lower levels of albumin in the serum.

In severe liver disease, various factors contribute to the decrease in serum albumin, including impaired protein synthesis and the potential for related conditions such as ascites, which can affect the body's overall protein levels. Monitoring serum albumin is important because it helps assess the nutritional status of patients and the severity of liver disease.

The other conditions listed can affect albumin levels differently. For example, kidney disease can lead to protein loss through urine if nephrotic syndrome or another condition is present, while dehydration can actually concentrate serum proteins, including albumin, resulting in higher levels. Heart failure can cause fluctuating albumin levels but does not typically result in a significant reduction like severe liver disease would.