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 A
Explanation
A. Shortness of breath while lying down. Shortness of breath when lying down, or orthopnea, is common in left-sided heart failure due to fluid backing up into the lungs, causing pulmonary congestion.
B. Jugular venous distention. Jugular venous distention is more commonly associated with right-sided heart failure due to systemic venous congestion.
C. Right upper quadrant pain. Right upper quadrant pain is associated with liver congestion due to right-sided heart failure, not left-sided heart failure.
D. Pitting edema of the lower legs. Pitting edema is a symptom of right-sided heart failure, as fluid backs up into the peripheral circulation.
Correct Answer is D
Explanation
A. Partial thromboplastin time (PTT) 55 seconds: This PTT value is within the therapeutic range for a client on heparin therapy.
B. Hematocrit 45%: This hematocrit value is within normal limits and is not concerning.
C. White blood cell count 8,000/mm³: A WBC count of 8,000/mm³ is within the normal range and does not require reporting.
D. Platelets 74,000/mm³: A low platelet count (thrombocytopenia) can indicate heparin-induced thrombocytopenia (HIT), a potentially serious complication of heparin therapy.