Author Question: After an acute myocardial infarction of the left ventricle, a client has irreversible cellular ... (Read 35 times)

saraeharris · **on:** Jul 23, 2018

After an acute myocardial infarction of the left ventricle, a client has irreversible cellular necrosis of the myocardium. The nurse planning care determines that which nursing diagnosis would be the highest priority at this time?

1. Activity Intolerance
2. Infection, Risk for
3. Breathing Pattern, Ineffective
4. Cardiac Output, Decreased

Question 2

A nurse educator is discussing what happens when cardiac cells die. Which consequences are appropriate for the educator to include in the discussion?

Standard Text: Select all that apply.
1. Fibrotic scar tissue formation
2. Impaired cardiac function
3. Extensive branching
4. Impaired cardiac contraction
5. Left ventricular hypertrophy

manuelcastillo · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 4
Rationale 1: After a myocardial infarction of the left ventricle, a client might experience Activity Intolerance, but it is not the priority nursing diagnosis at this time.
Rationale 2: This client is not at high Risk for Infection at this time.
Rationale 3: Ineffective Breathing Pattern is associated with heart failure, and is not the priority at this time.
Rationale 4: Forward flow of blood could be impaired if a portion of the left ventricle myocardium is replaced with scar tissue. This will reduce stroke volume and cardiac output.
Global Rationale: Forward flow of blood could be impaired if a portion of the left ventricle myocardium is replaced with scar tissue. This will reduce stroke volume and cardiac output. After a myocardial infarction of the left ventricle, a client might experience Activity Intolerance, but it is not the priority nursing diagnosis at this time. This client is not at high Risk for Infection at this time. Ineffective Breathing Pattern is associated with heart failure, and is not the priority at this time.

Answer to Question 2

Correct Answer: 1,2,4,5
Rationale 1: If a large area of the myocardium becomes deprived of oxygen and undergoes necrosis, the cells are replaced by fibrotic scar tissue.
Rationale 2: If a large area of the myocardium becomes deprived of oxygen and undergoes necrosis, impaired cardiac function can occur.
Rationale 3: Extensive branching is not a consequence of cardiac cell death.
Rationale 4: If a large area becomes deprived of oxygen and undergoes necrosis, the different regions of the heart may not contract in a coordinated manner because conduction of the electrical potential may skip over spots on the myocardium where no conduction occurs.
Rationale 5: During heart failure, the size of the left ventricle and the thickness of the myocardial layer in this chamber can increase in size in clients, which is a condition known as left ventricular hypertrophy.
Global Rationale: If a large area of the myocardium becomes deprived of oxygen and undergoes necrosis, the cells are replaced by fibrotic scar tissue and impaired cardiac function can occur. If a large area becomes deprived of oxygen and undergoes necrosis, the different regions of the heart may not contract in a coordinated manner because conduction of the electrical potential may skip over spots on the myocardium where no conduction occurs. During heart failure, the size of the left ventricle and the thickness of the myocardial layer in this chamber can increase in size in clients, which is a condition known as left ventricular hypertrophy. Extensive branching is not a consequence of cardiac cell death.