A 60-year-old male client was hospitalized 3 days ago with the diagnosis of acute anterior wall myocardial infarction. Today he has been complaining of increasing weakness and shortness of breath. Crackles in both lung bases are audible on auscultation.

A 60-year-old male client was hospitalized 3 days ago with the diagnosis of acute anterior wall myocardial infarction. Today he has been complaining of increasing weakness and shortness of breath. Crackles in both lung bases are audible on auscultation.

He is developing:
A . An extension of his myocardial infarction
B . Pneumonia
C . Pulmonary edema
D . Pulmonary emboli

View Answer

Answer: C

Explanation:

(A) Extensions of his myocardial infarction would be chest pain unrelieved with nitroglycerin, cardiac enzyme elevations, and electrocardiographic changes.

(B) Persons with pneumonia may complain of weakness and shortness of breath and have crackles in their lung bases.

However, they would also have sputum production and leukocytosis.

(C) Persons who have had myocardial infarctions (especially anterior wall) are at risk of developing left ventricular heart failure, which is a major cause of pulmonary edema. Pulmonary edema is manifest by shortness of breath, weakness, and crackles on auscultation of the lung fields.

(D) Pulmonary emboli may be accompanied by shortness of breath, weakness, and crackles.

However, the pulmonary hypertension that accompanies pulmonary emboli results in signs of increased systemic venous pressure as well.