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Troponin I (cTNL) Lab Values
Overview
Troponin I
Normal value range
Pathophysiology
Special considerations
Elevations in lab values
Nursing Points
General
Normal value range
Typically, less than 0.035 ng/mL or less
Can vary among institutions
Has to be greater than the 99th percentile
Pathophysiology
Troponin is released during myocardial cell damage
Decreased perfusion causes myocardial cell damage
Causes of myocardial cell damage
Myocardial infarction
Demand ischemia
Cardiogenic
ACS
Noncardiogenic
Sepsis
Renal failure
Extreme exercise
Special considerations
Submitted in green top tube
Value peak
Detection 6-12 hours after acute injury
Peaks 24 hours after injury
Can stay elevated for a week
Knowing patient history is critical
Increased values
Any elevated value is typically considered critical
Acute elevations warrant immediate investigation
Typically PCI (percutaneous coronary intervention)/Angiography and EKG to rule out MI or ACS (acute coronary syndrome)
Other elevations
CABG
Extreme exercise
End Stage Renal Failure
Assessment
Assess for:
Acute chest pain
Symptoms of MI
Nausea
Vomiting
Angina in any form
Reflux (especially in women)
Therapeutic Management
EKG
Angiography or PCI
Management of non-cardiogenic etiology
Nursing Concepts
Lab Values
Perfusion
Patient Education
Educate patient on keeping history of elevated levels or cardiac disease for future reference
Educate patient on duration of elevated troponin levels, post injury
View all episodes
By Jon Haws RN: Critical Care Nurse & NCLEX Educator
4.3
127127 ratings
Overview
Troponin I
Normal value range
Pathophysiology
Special considerations
Elevations in lab values
Nursing Points
General
Normal value range
Typically, less than 0.035 ng/mL or less
Can vary among institutions
Has to be greater than the 99th percentile
Pathophysiology
Troponin is released during myocardial cell damage
Decreased perfusion causes myocardial cell damage
Causes of myocardial cell damage
Myocardial infarction
Demand ischemia
Cardiogenic
ACS
Noncardiogenic
Sepsis
Renal failure
Extreme exercise
Special considerations
Submitted in green top tube
Value peak
Detection 6-12 hours after acute injury
Peaks 24 hours after injury
Can stay elevated for a week
Knowing patient history is critical
Increased values
Any elevated value is typically considered critical
Acute elevations warrant immediate investigation
Typically PCI (percutaneous coronary intervention)/Angiography and EKG to rule out MI or ACS (acute coronary syndrome)
Other elevations
CABG
Extreme exercise
End Stage Renal Failure
Assessment
Assess for:
Acute chest pain
Symptoms of MI
Nausea
Vomiting
Angina in any form
Reflux (especially in women)
Therapeutic Management
EKG
Angiography or PCI
Management of non-cardiogenic etiology
Nursing Concepts
Lab Values
Perfusion
Patient Education
Educate patient on keeping history of elevated levels or cardiac disease for future reference
Educate patient on duration of elevated troponin levels, post injury
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