During the second day of hospitalization of the client after a Myocardial Infarction. Which of the following is an expected outcome?
A. Able to perform self-care activities without pain
B. Severe chest pain
C. Can recognize the risk factors of Myocardial Infarction
D. Can Participate in cardiac rehabilitation walking program
Correct Answer: A. Able to perform self-care activities without pain
By the 2nd day of hospitalization after suffering a Myocardial Infarction, clients are able to perform care without chest pain. Instruct the patient to report pain immediately. Provide a quiet environment, calm activities, and comfort measures. Approach the patient calmly and confidently. Decreases external stimuli, which may aggravate anxiety and cardiac strain, limit coping abilities, and adjustment to the current situation.
Option B: Severe chest pain during the second day of hospitalization of the client should be a cause of immediate concern. Monitor and document characteristics of pain, noting verbal reports, nonverbal cues (moaning, crying, grimacing, restlessness, diaphoresis, clutching of chest) and BP or heart rate changes.
Option C: The client may recognize the risks of MI but not necessarily on the second day of hospitalization. Review history of previous angina, anginal equivalent, or MI pain. Discuss family history if pertinent. Delay in reporting pain hinders pain relief and may require an increased dosage of medication to achieve relief. In addition, severe pain may induce shock by stimulating the sympathetic nervous system, thereby creating further damage and interfering with diagnostics and relief of pain.
Option D: A cardiac rehabilitation walking program might be too soon for the client, but can be included in the discharge instructions. Explain the pattern of graded increase of activity level: getting up to commode or sitting in a chair, progressive ambulation, and resting after meals. Progressive activity provides a controlled demand on the heart, increasing strength and preventing overexertion.