Dx Test And Procedures

Question 1

Cardiac Enzymes

Answer 1

CK-MB
Lactate dehydrogenase (LDH)
Troponin
Myoglobin

Question 2

CK-MB

Answer 2

0% to 5% of total; total = 26 to 174 units/L

Elevation occurs within hours and peaks at 18hrs

Question 3

Lactate dehydrogenase (LDH)

Answer 3

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

Question 4

Troponin

Answer 4

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

Question 5

Myoglobin

Answer 5

Oxygen binding protein found in cardiac and skeletal muscle

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

Question 6

CBC Exams

Answer 6

RBC
WBC
Hematocrit
Hemoglobin

Question 7

RBC

Answer 7

Decreases in rheumatic heart disease and infective endocarditis

Increases in conditions characterized by inadequate tissue oxygenation

Question 8

WBC

Answer 8

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

Needed to dispose of necrotic tissue

Question 9

Hematocrit

Answer 9

Elevated level can result from vascular volume depletion

Question 10

Hemoglobin

Answer 10

Decrease can indicate anemia along with hematocrit levels

Question 11

Blood Coagulation Factors

Answer 11

Increase can occur during and after MI

Grater risk for thrombophlebitis and extension of clots in the coronary arteries

Question 12

Serum Lipids

Answer 12

Serum cholesterol
Triglyceride
Lipoprotein

Question 13

Homocysteine

Answer 13

Less than 14mmol/dL

Elevated levels increase the risk of cardiovascular disease

Question 14

Highly sensitive C-reactive protein (hsCRP)

Answer 14

Detects inflammatory process associated with atherothrombosis

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

Question 15

Microalbuminuria

Answer 15

Small amt. marked for endothelial dysfunction in cardiovascular disease

Question 16

Electrolytes

Answer 16

Potassium
Sodium
Calcium
Phosphorus
Magnesium

Question 17

BUN

Answer 17

8 to 25 mg/dL

Elevated in heart disorders (HF and Cardiogenic shock)

Question 18

Blood Glucose

Answer 18

Elevated in acute cardiac episode

Question 19

B-type natriuretic peptide (BNP)

Answer 19

Normal < 100pg/mL

Marker for CHF

Question 20

Other Dx tests

Answer 20

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

Question 21

Cardiac Catheterization PreOp

Answer 21

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

Question 22

Cardiac Cath patient teaching

Answer 22

Pt may feel fatigue due to lying still for up to 2hrs

Pt may feel flushed, warm, desire to cough, and palpitations

Question 23

Cardiac catheterization post op

Answer 23

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