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Information

Synonym/Acronym

Zn.

Rationale

To assist in assessing for zinc deficiency or toxicity, monitor therapeutic interventions, and assist in diagnosing disorders related to healing and immune function.

Patient Preparation

There are no food, fluid, activity, or medication restrictions unless by medical direction.

Normal Findings

Method: Inductively Coupled Plasma-Mass Spectrometry.

Conventional UnitsSI Units (Conventional Units × 0.153)
60–120 mcg/dL0.92–18.4 micromol/L

Critical Findings and Potential Interventions

N/A

Overview

Study type: Blood collected in a trace element-free, royal blue-top tube; related body system: Multisystem.

Zinc is found in all body tissues, but the highest concentrations are found in the eye, bone, and male reproductive organs. Zinc is involved in RNA and DNA synthesis and is essential in the process of tissue repair. It is also required for the formation of collagen and the production of active vitamin A (for the visual pigment rhodopsin). Zinc also functions as a chelating agent to protect the body from lead and cadmium poisoning. Zinc is absorbed from the small intestine. Its absorption and excretion seem to be through the same sites as those for iron and copper. The body does not store zinc as it does copper and iron. Untreated zinc deficiency in infants may result in a condition called acrodermatitis enteropathica. Symptoms include delayed growth, diarrhea, impaired wound healing, and frequent infections. Adolescents and adults with zinc deficiency exhibit similar adverse effects on growth, sexual development, and immune function, as well as altered taste and smell, emotional instability, impaired adaptation to darkness, impaired night vision, tremors, and a bullous, pustular rash over the extremities.

Indications

Interfering Factors

Factors That May Alter the Results of the Study

  • Drugs and other substances that may increase zinc levels include auranofin, chlorthalidone, corticotropin, oral contraceptives, and penicillamine.
  • Drugs and other substances that may decrease zinc levels include anticonvulsants, cisplatin, citrates, corticosteroids, estrogens, interferon, oral contraceptives, and prednisone.

Potential Medical Diagnosis: Clinical Significance of Results

Increased In

Zinc is contained in and secreted by numerous types of cells in the body. Damaged cells release zinc into circulation and increase blood levels.

  • Anemia (related to competitive relationship with copper; copper deficiency is associated with decreased production of red blood cells)

Decreased In

This trace metal is an essential component of enzymes that participate in protein and carbohydrate metabolism. It is involved in DNA replication, insulin storage, carbon dioxide gas exchange, cellular immunity and healing, promotion of body growth, and sexual maturity. Deficiencies result in a variety of conditions.

  • Acrodermatitis enteropathica (congenital abnormality that affects zinc uptake and results in zinc deficiency)
  • AIDS
  • Acute infections
  • Acute stress
  • Burns
  • Cirrhosis
  • Conditions that decrease albumin (related to lack of available transport proteins)
  • Diabetes
  • Long-term total parenteral nutrition
  • Malabsorption
  • Myocardial infarction
  • Nephrotic syndrome
  • Nutritional deficiency
  • Pregnancy (related to increased uptake by fetus; related to excessive levels of iron and folic acid prescribed during pregnancy and which interfere with absorption)
  • Pulmonary tuberculosis

Nursing Implications, Nursing Process, Clinical Judgement

Before the Study: Planning and Implementation

Teaching the Patient What to Expect

  • Discuss how this test can assist in evaluating for disorders associated with abnormal zinc levels and monitor response to therapy.
  • Explain that a blood sample is needed for the test.

After the Study: Implementation & Evaluation Potential Nursing Actions

Treatment Considerations

  • Provide education regarding access to nutritional counseling services.

Nutritional Considerations

  • Topical or oral supplementation may be ordered for patients with zinc deficiency.
  • Dietary sources high in zinc include red meat, shellfish, nuts, wheat germ, and processed foods such as canned pork and beans and canned chili.
  • Patients should be informed that phytates (from whole grains, coffee, cocoa, or tea) bind zinc and prevent it from being absorbed.
  • Decreases in zinc also can be induced by increased intake of iron, copper, or manganese.
  • Vitamin and mineral supplements with a greater than 3:1 iron/zinc ratio inhibit zinc absorption.

Clinical Judgement

  • Consider ways to facilitate dietary changes and improve zinc deficiency.

Follow-Up and Desired Outcomes

  • Understands that depending on the results of this procedure, additional testing may be necessary to monitor disease progression and determine the need for a change in therapy.
  • Acknowledges contact information provided for the U.S. Department of Agriculture’s resource for nutrition (www.choosemyplate.gov).