Fifteen hours after admission, a patient's CK-MB level is markedly increased. What does this indicate to the treatment team?
1. Cellular necrosis of myocardial tissue has occurred.
2. Lactic acid is present.
3. Thrombolytic therapy is indicated.
4. Cardiac function has returned to normal.
1
Rationale 1: CK is the intracellular enzyme that is released when cell damage and death occur. CK-MB becomes elevated when myocardial cell death has occurred.
Rationale 2: The pH is the indicator of lactic acid buildup.
Rationale 3: Thrombolytic therapy is indicated within the first 12 hours after symptoms develop; thus, it is too late for this intervention.
Rationale 4: Cardiac function has not returned to normal.
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a. Give the dose as a fast intravenous (IV) bolus. b. Mix the drug with normal saline, and give it as a slow IV push. c. Mix the drug with dextrose (D5W), and give it as a slow IV push. d. Mix the drug with any available solution as long as the administration rate is correct.
Which statement about attitude is correct?
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