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Flashcards in Dx Test And Procedures Deck (23)
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1

Cardiac Enzymes

CK-MB
Lactate dehydrogenase (LDH)
Troponin
Myoglobin

2

CK-MB

0% to 5% of total; total = 26 to 174 units/L
Elevation occurs within hours and peaks at 18hrs

3

Lactate dehydrogenase (LDH)

Occurs 24hrs following MI
Peaks in 48 to 72 hrs
Normally LDH1 is lower than LDH2.
LDH 1 is higher than LDH2 (flipped) signifying myocardial necrosis.

140-280 international units/L

4

Troponin

Composed of three proteins
*Troponin C
*Troponin I- rises within 3hrs and persists for up to 7 to 10 days
*Troponin T- 0 to 0.2 ng/mL

5

Myoglobin

Oxygen binding protein found in cardiac and skeletal muscle

Rises within 2hrs after cell death
Rapid decline in the level after 7hrs

6

CBC Exams

RBC
WBC
Hematocrit
Hemoglobin

7

RBC

Decreases in rheumatic heart disease and infective endocarditis

Increases in conditions characterized by inadequate tissue oxygenation

8

WBC

Increases in infectious and inflammatory disease of the heart and after MI

Needed to dispose of necrotic tissue

9

Hematocrit

Elevated level can result from vascular volume depletion

10

Hemoglobin

Decrease can indicate anemia along with hematocrit levels

11

Blood Coagulation Factors

Increase can occur during and after MI
(Grater risk for thrombophlebitis and extension of clots in the coronary arteries)

12

Serum Lipids

Serum cholesterol
Triglyceride
Lipoprotein

13

Homocysteine

Less than 14mmol/dL

Elevated levels increase the risk of cardiovascular disease

14

Highly sensitive C-reactive protein (hsCRP)

Detects inflammatory process associated with atherothrombosis

Low - 1mg/dL
High- 3mg/dL (for heart disease)

15

Microalbuminuria

Small amt. marked for endothelial dysfunction in cardiovascular disease

16

Electrolytes

Potassium
Sodium
Calcium
Phosphorus
Magnesium

17

BUN

8 to 25 mg/dL

Elevated in heart disorders (HF and Cardiogenic shock)

18

Blood Glucose

Elevated in acute cardiac episode

19

B-type natriuretic peptide (BNP)

Normal < 100pg/mL

Marker for CHF

20

Other Dx tests

Chest X-Rays
Electrocardiography
Holster monitoring
Echocardiography
Exercise electrocardiography testing (stress)
Digital subtraction angio
Myocardial nuclear perfusion imaging (MNPI)
MRI
cardiac cath

21

Cardiac Catheterization PreOp

Allergies to seafood, iodine, or radiopaque
Withhold solid food for 6 to 8hrs, liquids 4hrs
Vaseline vital signs
Local anesthetic
Prepare insertion site
PreOp sedatives
IV line

22

Cardiac Cath patient teaching

Pt may feel fatigue due to lying still for up to 2hrs
Pt may feel flushed, warm, desire to cough, and palpitations

23

Cardiac catheterization post op

v/s at least every 30 min for 2hrs
Peripheral pulses and color
Warmth, sensation to distal site every 30min for 2hrs
Notify physician if pt complaints of numbness, tingling, if the extremity becomes cool, pale, or cyanosis, if loss of peripheral pulses occurs
Sandbag or compression device
Monitor for bleeding, hematoma
Maintain strict bed rest for 6 to 12 hrs
Do not elevate head of bed more than 15 degrees
Keep extremity extended for 4 to 6 hrs
If antecubital vessel was used immobilize arm
Encourage fluid intake
Monitor for n/v, rash, or other signs of hypersensitivity to the dye