Which activity is suitable for a client who suffered uncomplicated myocardial infarction (MI) 2-days ago?

DHS 2018 shift 1st

Medical Surgical Nursing

Easy

Appeared in: DHS 2018 shift 1st

Explanation

For a patient with an uncomplicated MI, activity must be increased gradually to recondition the heart safely.
Standard Phase 1 cardiac rehabilitation protocols indicate that on day 2 post-MI, the appropriate activity is sitting out of bed in a chair for short, supervised periods.
This level of activity helps prevent complications of immobility, such as deep vein thrombosis (DVT) and orthostatic hypotension, without placing excessive strain on the healing heart muscle.
The duration of 15 minutes, repeated three times, is a typical starting point to build tolerance.

Option B: This is too conservative for day 2. While appropriate for the first 24 hours, continuing strict bed rest increases the risk of complications like DVT, pneumonia, and muscle deconditioning.
Option C: This is too strenuous for day 2. Ambulation in the room and hallway places a significantly higher workload on the heart and is typically initiated on day 3 or 4.
Option D: This is too conservative for day 2. Sitting for only 5 minutes is more aligned with the initial mobilization efforts on day 1 (e.g., dangling legs at the bedside).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Cardiac Rehabilitation Phase 1 Activity Progression as background academic context rather than a clinical decision trigger.
Nurses are responsible for implementing the cardiac rehabilitation plan, carefully monitoring the patient's response to each increase in activity.
Before any activity, the nurse must assess vital signs and check for contraindications. During and after, the nurse monitors for signs of intolerance such as a heart rate increase of more than 20 bpm, chest pain, dyspnea, or dizziness.
Patient safety is paramount. Any signs of intolerance require immediate cessation of activity and notification of the primary provider.

How to Approach the Question

First, identify the key clinical details in the question: the diagnosis is 'uncomplicated myocardial infarction' and the timeline is '2-days ago'.
The word 'uncomplicated' is a signal that you should apply the standard, textbook protocol for recovery.
Recall the typical progression of activity in Phase 1 (inpatient) cardiac rehabilitation.
Mentally map out the activities for each day: Day 1 (bed rest/dangle legs), Day 2 (sit in chair), Day 3 (ambulate in room), Day 4 (ambulate in hall).
Evaluate each option against the expected activity for Day 2.
Select the option that precisely matches the standard protocol for the second day post-uncomplicated MI.

Concept Tested & Keywords

Concept Tested: Cardiac Rehabilitation Phase 1 Activity Progression
Stem keywords: uncomplicated myocardial infarction, MI, 2-days ago, suitable activity
Lead-in keywords: suitable
Clinical cues: Patient status 'uncomplicated' implies a standard recovery protocol should be followed.
Clinical cues: Timeline '2-days ago' is the key to selecting the correct stage of activity progression.

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 121-123