During the 48 hours after a myocardial infarction (MI), a nurse should assign the highest priority to monitoring the patient for what complication?

During the 48 hours after a myocardial infarction (MI), the highest priority for monitoring the patient is for dysrhythmias. After an MI, the heart's electrical system can be disrupted, leading to various types of abnormal heart rhythms (dysrhythmias). Dysrhythmias can be life-threatening and require prompt recognition and intervention.

Other options:

B) Anxiety and fear: Anxiety and fear are common emotional responses after an MI, but they are not the highest priority for monitoring during the immediate post-MI period. Emotional support and counseling are essential, but they do not require continuous monitoring.

C) Metabolic acidosis: Metabolic acidosis is not a common complication of an acute MI. It may occur in certain situations, such as when there is inadequate perfusion to tissues, but it is not the highest priority during the immediate post-MI period.

D) Medication side effects: Monitoring for medication side effects is important but is not the highest priority during the immediate post-MI period. Many patients will receive medications to manage pain, reduce clot formation, and stabilize their heart function. The nurse should monitor for side effects but not as a higher priority compared to dysrhythmias.

The client's presentation of chest pain radiating to the left arm, sweating, shortness of breath, epigastric discomfort, cool and diaphoretic skin, tachycardia, and ST elevation on the electrocardiogram (ECG) are indicative of myocardial infarction (heart attack). These symptoms and findings are typical of acute coronary syndrome, specifically an ST-segment elevation myocardial infarction (STEMI).

Option A (Ischemic Stroke) is not the correct answer because the symptoms described in the client's presentation are primarily related to the cardiovascular system and not indicative of an ischemic stroke.

Option B (Chronic Stable Angina) is not the correct answer because chronic stable angina typically presents with chest pain on exertion or stress, and it usually subsides with rest or nitroglycerin. The client's symptoms of chest pain at rest, along with other findings, are more concerning for an acute cardiac event like a myocardial infarction.

Option D (Cardiogenic Shock) is a severe complication that can occur following a myocardial infarction, but the information provided in the scenario does not suggest that the client is in cardiogenic shock at this time. The client's blood pressure is not mentioned in the scenario, which is a crucial parameter to assess for cardiogenic shock.