The nurse is caring for a patient in the emergency department who complain of chest pain. While watching the telemetry monitor, the nurse notes new S-T elevation in lead II. Which labs should the nurse anticipate being ordered for this patient?
a. Cardiac troponin T
b. Potassium level
c. Creatine kinase (CK)
d. B-type natriuretic peptide (BNP)
A
Cardiac-derived troponins (T and I) are considered the best serum markers for suspected STEMI. Cardiac troponins are detectable within 2 to 4 hours after symptom onset if infarction has oc-curred.
Measurement of the potassium level is not indicated. However, it should be evaluated in ST de-pression, which can be the result of hypokalemia or hyperkalemia.
A CK level is not specific enough. Unless specific isoenzymes are evaluated, it is not clear whether elevations are the result of other problems, such as musculoskeletal, cerebral, or renal injury.
BNP is used to diagnose heart failure.
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