Which of the following is an expected outcome for a client on the second day of hospitalization after an MI?
A. Has severe chest pain.
B. Can identify risk factors for MI.
C. Agrees to participate in a cardiac rehabilitation walking program.
D. Can perform personal self-care activities without pain.
Correct Answer: D. Can perform personal self-care activities without pain.
By day 2 of hospitalization after an MI, clients are expected to be able to perform personal care without chest pain. Pain is a subjective experience and must be described by the patient. Provides a baseline for comparison to aid in determining the effectiveness of therapy, resolution, and progression of the problem.
Option A: Severe chest pain should not be present. 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: Day 2 hospitalization may be too soon for clients to be able to identify risk factors for MI. 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 C: Day 2 hospitalization is too soon for the client to begin a walking program, however, the client may be sitting up in a chair as part of the cardiac rehabilitation program. Instruct the patient to do relaxation techniques: deep and slow breathing, distraction behaviors, visualization, guided imagery. Assist as needed.
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