July 17, 2023

Troponin I (cTNL) Lab Values

3 minutes

Overview

Troponin I
1. Normal value range
2. Pathophysiology
3. Special considerations
4. Elevations in lab values

Nursing Points General

Normal value range
1. Typically, less than 0.035 ng/mL or less
2. Can vary among institutions
3. Has to be greater than the 99th percentile
Pathophysiology
1. Troponin is released during myocardial cell damage
2. Decreased perfusion causes myocardial cell damage
3. Causes of myocardial cell damage
  1. Myocardial infarction
  2. Demand ischemia
    1. Cardiogenic
      1. ACS
    2. Noncardiogenic
      1. Sepsis
      2. Renal failure
      3. Extreme exercise
Special considerations
1. Submitted in green top tube
2. Value peak
  1. Detection 6-12 hours after acute injury
  2. Peaks 24 hours after injury
  3. Can stay elevated for a week
    1. Knowing patient history is critical
Increased values
1. Any elevated value is typically considered critical
2. Acute elevations warrant immediate investigation
  1. Typically PCI (percutaneous coronary intervention)/Angiography and EKG to rule out MI or ACS (acute coronary syndrome)
3. Other elevations
  1. CABG
  2. Extreme exercise
  3. End Stage Renal Failure

Assessment

Therapeutic Management

Nursing Concepts

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

...more

By Jon Haws RN: Critical Care Nurse & NCLEX Educator

4.3

127127 ratings

July 17, 2023

3 minutes

Overview

Troponin I
1. Normal value range
2. Pathophysiology
3. Special considerations
4. Elevations in lab values

Nursing Points General

Normal value range
1. Typically, less than 0.035 ng/mL or less
2. Can vary among institutions
3. Has to be greater than the 99th percentile
Pathophysiology
1. Troponin is released during myocardial cell damage
2. Decreased perfusion causes myocardial cell damage
3. Causes of myocardial cell damage
  1. Myocardial infarction
  2. Demand ischemia
    1. Cardiogenic
      1. ACS
    2. Noncardiogenic
      1. Sepsis
      2. Renal failure
      3. Extreme exercise
Special considerations
1. Submitted in green top tube
2. Value peak
  1. Detection 6-12 hours after acute injury
  2. Peaks 24 hours after injury
  3. Can stay elevated for a week
    1. Knowing patient history is critical
Increased values
1. Any elevated value is typically considered critical
2. Acute elevations warrant immediate investigation
  1. Typically PCI (percutaneous coronary intervention)/Angiography and EKG to rule out MI or ACS (acute coronary syndrome)
3. Other elevations
  1. CABG
  2. Extreme exercise
  3. End Stage Renal Failure

Assessment

Therapeutic Management

Nursing Concepts

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

...more