While doing client teaching about cardiac risk factors, the nurse knows that which of following laboratory tests, if abnormal, requires further teaching due to the risk for the development of coronary artery disease?
1. Elevated homocysteine
2. Elevated creatinine
3. Elevated high density lipoprotein (HDL)
4. Elevated INR
Elevated homocysteine
Rationale: Elevated levels of homocysteine (Hyc > 15 µmol/L) are associated with an increased risk of CAD. Homocysteine is an amino acid that is a by-product of the enzyme reactions from meat, dairy products, vitamin, and mineral metabolism. Homocysteine causes endothelial ulceration and scarring, and increases procoagulant properties of blood, all leading to an increase in the risk of thrombus formation. Elevated creatinine indicates kidney disease. HDL is the good cholesterol, and when elevated it will decrease the risk for the development of CAD. INR is a laboratory test that measures blood clotting function, not CAD.
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