Which client is at the highest risk for skin breakdown based on prealbumin levels?

Prealbumin is a protein that acts as a marker for nutritional status and liver function, reflecting the protein stores and overall nutritional intake of an individual. Low prealbumin levels indicate possible malnutrition and are associated with an increased risk of skin breakdown and pressure ulcers.

In this scenario, the client with a prealbumin level of 8.6 is at the highest risk for skin breakdown. This level falls significantly below the normal range, which is typically between 15 and 36 mg/dL. Levels below 10 mg/dL are particularly concerning and indicate severe malnutrition, which compromises the skin's health and integrity, making the client more susceptible to skin breakdown.

Higher prealbumin levels, such as 10.3, 12.7, and 15.2, while still showing some level of risk, do not indicate as severe a deficiency as the level of 8.6. Consequently, those clients are relatively better off regarding their nutritional status and wound healing capabilities, which helps protect against skin integrity issues.