A nurse is collecting data for a client who experienced a myocardial infarction prior to a cardiac arrest. Which of the following laboratory tests will identify early injury to the cardiac muscle?
Creatine kinase-myocardial band (CK-MB) test
Troponin T test
Brain natriuretic peptide (BNP) test
Creatine kinase (CK) test
The Correct Answer is B
A. Creatine kinase-myocardial band (CK-MB) test: While CK-MB is also a marker of myocardial injury, it is less specific than troponin and can be elevated in other conditions, such as muscle injury.
B. Troponin T test. The Troponin T test is highly specific and sensitive for myocardial injury and is considered the gold standard for diagnosing a myocardial infarction. Troponin levels rise within hours of cardiac muscle injury and remain elevated for days, providing an early and reliable indicator of cardiac muscle damage.
C. Brain natriuretic peptide (BNP) test. BNP levels are used to assess heart failure and do not indicate acute cardiac muscle injury.
D. Creatine kinase (CK) test. CK measures overall muscle injury, not specific to cardiac muscle.
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Correct Answer is D
Explanation
A. Depression: While propranolol can sometimes worsen symptoms of depression, this is not as critical as the impact on conditions like heart failure.
B. Glaucoma: Propranolol does not typically affect glaucoma; however, some beta-blockers are used to treat glaucoma.
C. Migraine: Propranolol is sometimes used to prevent migraines, so a history of migraines would not require discontinuation.
D. Heart failure: Propranolol can exacerbate heart failure by reducing myocardial contractility. Clients with heart failure require careful monitoring or an alternative medication.
Correct Answer is D
Explanation
A. Elevated thyroid hormone levels. While amiodarone can cause thyroid dysfunction, elevated thyroid levels (hyperthyroidism) would typically present with symptoms like increased energy or restlessness.
B. Low blood glucose levels. Low blood glucose is not related to amiodarone. Symptoms of hypoglycemia include sweating, hunger, and confusion, not heat intolerance or fatigue.
C. Elevated blood glucose levels. Hyperglycemia is not a known side effect of amiodarone.
D. Low thyroid hormone levels. Amiodarone can induce hypothyroidism, which may cause fatigue and heat intolerance. Regular thyroid monitoring is recommended with long-term amiodarone use.