Page 1669 - Saunders Comprehensive Review For NCLEX-RN

cell damage.
2. CK-MB (creatine kinase, myocardial muscle)
a. An elevation in value indicates
myocardial damage.
b. An elevation occurs within hours and
peaks at 18 hours following an acute
ischemic attack.
c. Normal value for CK-MB (CK-2) is 2 to
6 ng/mL (2 to 6 mcg/L) for males and 2
to 5 ng/mL (2 to 5 mcg/L) for females.
3. Myoglobin
a. Myoglobin is an oxygen-binding
protein found in cardiac and skeletal
muscle.
b. The level rises within 2 hours after cell
death, with a rapid decline in the level
after 7 hours; however, it is not cardiac
specific.
B. Complete blood count
1. The red blood cell count decreases in rheumatic heart
disease and infective endocarditis and increases in
conditions characterized by inadequate tissue
oxygenation.

2. The white blood cell count increases in

infectious and inflammatory diseases of the heart and
after MI, because large numbers of white blood cells
are needed to dispose of the necrotic tissue resulting
from the infarction.
3. An elevated hematocrit level can result from vascular
volume depletion.
4. Decreases in hemoglobin and hematocrit levels can
indicate anemia.
C. Blood coagulation factors: An increase in coagulation

factors can occur during and after MI, which places the client at
greater risk for thrombophlebitis and formation of clots in the
coronary arteries.
D. Serum lipids (refer to Chapter 10)
1. The lipid profile measures serum cholesterol,
triglyceride, and lipoprotein levels.
2. The lipid profile is used to assess the risk of
developing coronary artery disease.
3. Lipoprotein-a or Lp(a), a modified form of low-density
lipoprotein (LDL), increases atherosclerotic plaques
and increases clots; value should be less than
30 mg/dL (300 mg/L).

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