Nokea
The patient has a homocysteine level ordered. What aspects of this test should inform the nurses care? Select all that apply.
- A. A 12-hour fast is necessary before drawing the blood sample
- B. Recent inactivity can depress homocysteine levels
- C. Genetic factors can elevate homocysteine levels
- D. A diet low in folic acid elevates homocysteine levels
- E. An ECG should be performed immediately before drawing a sample
Correct Answer: A,C,D
Rationale: Genetic factors and a diet low in folic acid, vitamin B6, and vitamin B12 are associated with elevated homocysteine levels. A 12-hour fast is necessary before drawing a blood sample for an accurate serum measurement. An ECG is unnecessary and recent inactivity does not influence the results of the test.
You may also like to solve these questions
The nurse is caring for a patient admitted with unstable angina. The laboratory result for the initial troponin I is elevated in this patient. The nurse should recognize what implication of this assessment finding?
- A. This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours
- B. Because the patient has a history of unstable angina, this is a poor indicator of myocardial injury
- C. This is an accurate indicator of myocardial injury
- D. This result indicates muscle injury, but does not specify the source
Correct Answer: C
Rationale: Troponin I, which is specific to cardiac muscle, is elevated within hours after myocardial injury. Even with a diagnosis of unstable angina, this is an accurate indicator of myocardial injury.
The nurse is caring for a patient admitted with angina who is scheduled for cardiac catheterization. The patient is anxious and asks the reason for this test. What is the best response?
- A. Cardiac catheterization is usually done to assess how blocked or open a patients coronary arteries are
- B. Cardiac catheterization is most commonly done to detect how efficiently a patients heart muscle contracts
- C. Cardiac catheterization is usually done to evaluate cardiovascular response to stress
- D. Cardiac catheterization is most commonly done to evaluate cardiac electrical activity
Correct Answer: A
Rationale: Cardiac catheterization is usually used to assess coronary artery patency to determine if revascularization procedures are necessary. A thallium stress test shows myocardial ischemia after stress. An ECG shows the electrical activity of the heart.
The critical care nurse is caring for a patient who has had an MI. The nurse should expect to assist with establishing what hemodynamic monitoring procedure to assess the patients left ventricular function?
- A. Central venous pressure (CVP) monitoring
- B. Pulmonary artery pressure monitoring (PAPM)
- C. Systemic arterial pressure monitoring (SAPM)
- D. Arterial blood gases (ABG)
Correct Answer: B
Rationale: PAPM is used to assess left ventricular function. CVP is used to assess right ventricular function; SAPM is used for continual assessment of BP. ABG are used to assess for acidic and alkalotic levels in the blood.
The nurse is caring for a patient who has a history of heart disease. What factor should the nurse identify as possibly contributing to a decrease in cardiac output?
- A. A change in position from standing to sitting
- B. A heart rate of 54 bpm
- C. A pulse oximetry reading of 94%
- D. An increase in preload related to ambulation
Correct Answer: B
Rationale: Cardiac output is computed by multiplying the stroke volume by the heart rate. Cardiac output can be affected by changes in either stroke volume or heart rate, such as a rate of 54 bpm. An increase in preload will lead to an increase in stroke volume. A pulse oximetry reading of 94% does not indicate hypoxemia, as hypoxia can decrease contractility. Transitioning from standing to sitting would more likely increase rather than decrease cardiac output.
A brain (B-type) natriuretic peptide (BNP) sample has been drawn from an older adult patient who has been experienced vital fatigue and shortness of breath. This test will allow the care team to investigate the possibility of what diagnosis?
- A. Pleurisy
- B. Heart failure
- C. Valve dysfunction
- D. Cardiomyopathy
Correct Answer: B
Rationale: The level of BNP in the blood increases as the ventricular walls expand from increased pressure, making it a helpful diagnostic, monitoring, and prognostic tool in the setting of HF. It is not specific to cardiomyopathy, pleurisy, or valve dysfunction.