Five days after an MI, a patient reports chest fullness and dyspnea. The nurse should assess for which symptoms?

Five days after an MI, a patient reports chest fullness and dyspnea. The nurse should assess for which symptoms?

• A. Headache
• B. Abdominal pain
• C. Numbness in fingers
• D. Cough and dyspnea

Answer: (D)

The main concept here is recognizing signs of left‑sided heart failure with pulmonary congestion after a myocardial infarction. Five days after an MI, new or worsening chest fullness and shortness of breath often point to developing heart failure as the damaged heart struggles to pump effectively. The best symptom to assess in this situation is a cough that accompanies the dyspnea, because cough is a classic manifestation of pulmonary edema resulting from fluid backing up into the lungs. This dyspnea–cough combination reflects impaired gas exchange from fluid in the alveoli and is often accompanied by lung crackles, possible orthopnea, and, if more advanced, frothy sputum. Other symptoms listed—headache, abdominal pain, or numbness in the fingers—don’t align with this scenario of post-MI left‑sided heart failure and pulmonary congestion, so they’re not the priority signs to evaluate here. If coughing and dyspnea are present, the nurse should further assess respiratory status and signs of heart failure and prepare for appropriate interventions as ordered.

The main concept here is recognizing signs of left‑sided heart failure with pulmonary congestion after a myocardial infarction. Five days after an MI, new or worsening chest fullness and shortness of breath often point to developing heart failure as the damaged heart struggles to pump effectively. The best symptom to assess in this situation is a cough that accompanies the dyspnea, because cough is a classic manifestation of pulmonary edema resulting from fluid backing up into the lungs. This dyspnea–cough combination reflects impaired gas exchange from fluid in the alveoli and is often accompanied by lung crackles, possible orthopnea, and, if more advanced, frothy sputum.

Other symptoms listed—headache, abdominal pain, or numbness in the fingers—don’t align with this scenario of post-MI left‑sided heart failure and pulmonary congestion, so they’re not the priority signs to evaluate here. If coughing and dyspnea are present, the nurse should further assess respiratory status and signs of heart failure and prepare for appropriate interventions as ordered.