CH 35 Cardiac Laboratory tests
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| use to determine acid base balance | Arterial Blood Gases
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| which organ regulates PaCO2? Which one regulates HCO3 | lungs; kidneys
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| ABG pre-op | 1) tell pt of ARTERIAL PUNCTURE 2) obtain HEPARINIZED syringe and draw sample
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| ABG post-op | 1) REMOVE AIR BUBBLES from sample 2) place TUBE ON ICE and send for IMMEDIATE analysis 3) apply PRESSURE to puncture for 5 mins. 4) report results
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| Pulse ox measures ____ ____ saturation | arterial oxygen
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| metabolic range of HCO3 | 35-45
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| PaCO2 range | 22-26
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| substance that is released when cardiac cells die as a result of damage | cardiac enzymes
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| 3 areas where creatine phosphokinase found in high concentrations: | brain, heart, skeletal muscle
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| type of creatine phosphokinase (CPK) specific to heart tissue is: | CPK-MB
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| CPK rise, peak, return to normal: | 4-6 hours after AMI, 12-24hrs, RETURN TO NORMAL in 2-3 days
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| Name two cardiac protein markers | troponin and myoglobin
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| protein involved in contraction of muscles | Troponin T and I
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| Troponin is released into circulation after what event | AMI
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| T or F: Normal levels of troponin are detectable in healthy individuals | false: troponin is usually not detectable in healthy individuals
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| T or false: Troponin elevate significantly with angina and AMI | false: elevates significantly with AMI only and lesser with angina
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| Which lab test is done in an emergency department and why? | troponin because it is quicker than enzymes (slower than myoglobin..myo is the fastest but not specific to the heart)
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| CPK pre-op | 1) tell that blood sample is drawn 2) no special prep 3)draw specimen before other invasive procedure to detect AMI
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| CPK post-op | 1) check VENIPUNCTURE 2) apply pressure when oozing
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| Troponin pre-op | tell blood will be drawn; no special prep
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| troponin post-op | same as cardiac enzymes
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| protien released very quickly after an AMI: the fastest | Myoglobin
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| T or F: myoglobin lvls elevate after muscle damage of any cause | True, it is elevated with any muscle because it is not specific to the heart muscle
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| Mrs. Gorcyca said that with myoglobin other tests are ordered: name 3 | 1) MRI 2) troponin 3) CPK
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| myoglobin post and pre op | same as troponin
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| What are the 5 things included in CBC tests: hint first is WBC | WBC, RBC, Hematocrit, hemoglobin, platelet
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| this count indicates body's ability to defend itself, give the normal range | WBC = 5,000-10,000
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| in what two conditions are WBC elevated according to the book? what conditions are WBC below normal | 1) inflammatory processes such as AMI and bacterial infection 2) viral infection and bone marrow depression
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| determines ability of blood to carry O2 from lungs to tissues and CO2 to lungs; give normal range | RBC = 3,600,000-5,400,000 ....lots of zeros
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| RBCs are below when and elevated when | below = anemias, malignancies; elevated = dehydration
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| percentage of packed RBCs; give normal range | Hct = 37-54%
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| transports O2 to cells; give normal range | hgb = 12-17.5
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| T or F: HGB is elevated in COPD, Dehydration and CHF | True
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| what level of HGB leads to heart failure | less than (<) 5
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| smallest element in blood necessary for coagulaton; normal range is | platelets= 150,000-350,000
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| anemia and bleeding range | below normal platelet, RBC, Hct, Hgb
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| during some heart disease and acute infections, platelet counts are elevated or depressed? | elevated
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| battery test measuring serum lipids | Lipid profile
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| what are the 3 most common lipids | cholesterol, triglycerides, and lipoprotiens
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| normal adult serum lvl of cholesterol is: | less than 200md/dL
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| Elevated cholesterol lvls are associated w/ risks for 3 conditions | AMI, hypertnesion, CAD
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| HDLs and LDLs are associated w/ what cardiac disorder | CAD
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| give levels for HDL, LDL, and Triglyceride levels | HDL= greater than 40; LDL less than 100; less than 150
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| what can you do to raise low lvls of HDL | physical activity at least 30 q day; no smoking; losing weight
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| Lipid pre op | 1) tell pt expect venipuncture 2) NPO 12HR BEFORE SAMPLE DRAWN 3) USUAL DIET for 2 weeks before procedure
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| lipid post op | same as cardiac enzymes
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| a cardiac hormone released during ventricular dilation and stretch (HF) | BNP = B-type natriuretic peptide
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| an acute phase protein and marker of inflammation | CRP= C-reactive protein
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| CRP can indicate what cardiac disorder | acute coronary syndrome ACS
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| BNP and CRP pre-op | tell blood is drawn, no special prep
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| BNP & CRP post op | same as cardiac enzyme
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| THE | END
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