Medical Surgical Cardiomyopathy #1

Question

The nurse is caring for a client who is admitted with a diagnosis of dilated cardiomyopathy. Assessment includes analysis of which laboratory results that would be used to prioritize assessment findings?

Answers

  1. Electrolyte panel, specifically sodium levels
    • Rationale:

      This answer is correct because the priority laboratory test in dilated cardiomyopathy is an electrolyte panel. Excess sodium in the blood will affect the cardiac excitability and conduction system of the heart in dilated cardiomyopathy, since the heart cannot pump enough blood out to the body resulting in decreased cardiac output.

  2. Kidney function panel, GFR, Serum Creatinine, and BUN
    • Rationale:

      This answer is not correct because although kidney function may eventually be affected, it is not diagnostic for initial diagnosis of dilated cardiomyopathy. The priority laboratory test in dilated cardiomyopathy is an electrolyte panel.

  3. Liver function panel, specifically AST, ALT, and bilirubin
    • Rationale:

      This answer is not correct because although liver function may eventually be affected, it is not diagnostic for initial diagnosis of dilated cardiomyopathy. The priority laboratory test in dilated cardiomyopathy is an electrolyte panel, specifically sodium levels.

  4. White blood cell panel, specifically lymphocytes
    • Rationale:

      This answer is not correct because dilated cardiomyopathy is not an infectious process so obtaining a white blood cell panel is not appropriate. The priority laboratory test in dilated cardiomyopathy is an electrolyte panel.

Overview

The priority laboratory test in dilated cardiomyopathy is an electrolyte panel. Excess sodium in the blood will affect the cardiac excitability and conduction system of the heart in dilated cardiomyopathy, since the heart cannot pump enough blood out to the body resulting in decreased cardiac output.

Explanation

Learning Outcomes

In dilated cardiomyopathy, dilation of the cardiac chambers and congested failure may occur. This is because cardiomyopathy is a disorder of the heart muscle that causes abnormal myocardial performance and is not usually the result of disease. The cardiac sodium channel is important in the cardiac excitability and conduction system. Excess sodium will affect the heart since it cannot pump enough blood out to the body resulting in decreased cardiac output. Edema, pulmonary crackles, and irregular heart rate may occur, and treatment may include use of diuretics and sodium restricted diet. Types of cardiomyopathy include dilated, hypertrophic, and restrictive. Dilated cardiomyopathy is the most common form.

Test Taking Tip

Understanding electrolytes and their effects in the body helps the test taker consider the choice if it is associated with the described condition. For example, dilated cardiomyopathy is cardiac related and sodium affects the excitability and conduction system of the heart. This would be a much better choice to consider rather than the white blood cell level since that would be most associated with infection.

Video Rationale