An older adult had a myocardial infarction (mi) 4 days ago. at 0930, the client's blood pressure is 102/64 mm hg. after reviewing the client's progress notes (see chart), the nurse should first:

The answer is notifying the healthcare provider. In addition all of the 12 pm assessments are signs of decreased cardiac output and can be an ominous sign in a patient that has recently experienced a myocardial infarction. The nurse must notify the healthcare provider of these changes. The cardiac output and blood pressure may continue to fall to dangerous levels in which can persuade additional coronary ischemia and extension of the infarct. While the patient is currently hypotensive giving a fluid challenge/bolus can precipitate improved workload on a damaged heart and extend the myocardial infarction. Exercise or walking for this patient will increase together the heart rate and stroke volume, both of which will increase cardiac output, but the increased cardiac output will increase oxygen needs especially in the heart muscle and can induce further coronary ischemia and extension of the infarct. The patient is hypotensive even though the patient has decreased urinary output, this is the reaction of the body to a declining cardiac output and it is not suitable to govern furosemide.

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