Osmosis from Elsevier - Cardiac biomarkers - Creatine kinase (CK): Clinical Nursing Care
A 71-year-old female with a history of high cholesterol and diabetes presents with chest pressure and nausea, leading to a suspicion of acute coronary syndrome. The provider orders a creatine kinase (CK) test to assess cardiac damage. CK is an enzyme that helps produce ATP, an energy source for body tissues. There are three types of CK: CK-MB (heart muscle), CK-MM (skeletal muscle), and CK-BB (brain). CK-MB levels rise when cardiac or skeletal muscle cells are damaged, releasing CK-MB into the bloodstream. Conditions like acute coronary syndrome, myocardial infarction, and rhabdomyolysis can cause such damage.
Nursing implications for elevated CK-MB include collecting blood samples, administering medications like aspirin, morphine, and nitroglycerin, providing oxygen, and ensuring continuous cardiac monitoring. Nurses should also prepare patients for potential cardiac interventions. The video emphasizes the importance of CK-MB in diagnosing cardiac issues and guiding treatment to prevent complications.
Key Points:
- CK-MB is a key cardiac biomarker for diagnosing heart muscle damage.
- Elevated CK-MB levels indicate damage to cardiac or skeletal muscle cells.
- Nursing care includes blood sample collection, medication administration, and cardiac monitoring.
- Medications like aspirin and nitroglycerin help manage symptoms and prevent complications.
- Continuous monitoring and preparation for interventions are crucial for patient care.
Details:
1. 🚑 Emergency Department Arrival
- A 71-year-old female with a history of high cholesterol and diabetes presents with chest pressure and nausea.
- Provider suspects acute coronary syndrome and orders a creatine kinase test.
- The initial assessment includes checking vital signs, conducting an ECG, and administering aspirin as a precautionary measure.
- The patient is placed on continuous cardiac monitoring to observe any changes in heart rhythm.
2. 🧬 Understanding Creatine Kinase (CK)
- Creatine kinase (CK), also known as creatine phosphokinase (CPK), is an enzyme crucial for the creation of adenosine triphosphate (ATP), which is a primary energy source for cellular functions.
- CK plays a vital role in muscle contraction and is often measured to diagnose conditions like myocardial infarction, where CK levels rise due to muscle damage.
- Elevated CK levels can indicate muscle diseases such as muscular dystrophy or conditions involving muscle breakdown.
- Monitoring CK levels is essential in managing and diagnosing conditions related to muscle damage, providing insights into both acute and chronic muscle issues.
3. ❤️ CKMB: The Cardiac Biomarker
- CKMB is primarily found in heart muscle cells (myocytes), with minor presence in skeletal muscle, indicating its importance in cardiac health monitoring.
- For cardiac events, CKMB serves as a crucial biomarker due to its high concentration in heart tissues, providing specific insights into cardiac muscle damage.
- In contrast, CKMM and CKBB are predominantly located in skeletal muscle and brain respectively, emphasizing CKMB's role in distinguishing cardiac issues from other muscular or neurological conditions.
4. 💔 Cardiac and Skeletal Muscle Damage
4.1. Cardiac Muscle Damage
4.2. Skeletal Muscle Damage
5. 📈 Measuring CKMB Levels
- CKMB is a cardiac enzyme used as a biomarker for heart muscle damage, making it crucial in diagnosing conditions like myocardial infarction.
- Elevated CKMB levels indicate potential cardiac issues, necessitating immediate medical attention to prevent further cardiac events.
- Nurses should prioritize care for clients with elevated CKMB levels, focusing on monitoring cardiac function and preparing for possible interventions.
- Incorporating case studies of patients with high CKMB levels can illustrate the importance of timely diagnosis and intervention.
- Clear communication between healthcare teams is essential to manage elevated CKMB levels effectively, ensuring patient safety and optimal outcomes.
6. 🩺 Nursing Care and Implications
6.1. Sample Collection and Laboratory Procedures
6.2. Medication Administration and Monitoring
6.3. Patient Monitoring and Preparation for Interventions
6.4. Rationale and Implications for Nursing Interventions
7. 🔍 Key Concepts Recap
- Creatine kinase (CK), also known as creatine phosphokinase, is a crucial enzyme in producing Adenosine Triphosphate (ATP), the primary energy source for body tissues.
- CK is categorized into three types: CK-MB, CK-MM, and CK-BB. CK-MB is predominantly found in the heart muscle and to a lesser extent in skeletal muscle, CK-MM is primarily located in skeletal muscle, and CK-BB is present in the brain.
- Elevated CK-MB levels indicate damage to myocytes or skeletal muscle cells, resulting in the release of CK-MB and other cellular contents into the bloodstream.
- Nursing implications involve assisting with treatment by monitoring CK levels, preventing complications through timely intervention, and supporting clinicians in knowledge retention and education. For example, monitoring CK-MB levels can guide treatment decisions for heart attack patients.