5'-Nucleotidase (5'-N), an isoenzyme of ALP, is a specific phosphomonoesterase formed in the hepatobiliary tissues. Elevated serum 5'-N levels are associated with biliary cirrhosis, carcinoma of the liver and biliary structures, and choledocholithiasis or other biliary obstruction.

• Elevated alkaline phosphatase of uncertain etiology:
  • Elevated 5'-N levels support the diagnosis of hepatobiliary disorders as the source of the elevated alkaline phosphatase.
  • Normal levels support the diagnosis of bone disease as the source of the elevated alkaline phosphatase.

Nursing Care Before the Procedure

Client preparation is the same as that for any test involving collection of a peripheral blood sample (see Appendix I).

A venipuncture is performed and the sample collected in a red-topped tube. The sample should be handled gently to avoid hemolysis and transported promptly to the laboratory.

Nursing Care After the Procedure

Care and assessment after the procedure are the same as for any study involving the collection of a peripheral blood sample.