The nurse on a medical surgical floor admits an 80-year-old patient who presents with shortness of breath, fatigue, and weight gain of 10 pounds in the last 3 days. The patient reports a history of myocardial infarction 15 years ago. The nurse suspects the patient has which of the following? 

Explanation

•People with a history of myocardial infarction are at an increased risk of developing congestive heart failure (CHF). This is due to damage to the heart muscle (myocardium) that occurs from ischemia (decreased oxygen) during a heart attack (MI). In this condition, the heart muscle is weakened and does not pump efficiently. Excess fluid builds up in the heart chambers, which then backs up into the lungs, causing shortness of breath.

•This process causes a backup of all circulatory blood and fluid resulting in excess fluid volume. This excess fluid volume causes an increase in weight. People with CHF need to weigh themselves daily and report a weight gain of 2 or more pounds in 24 hours or 5 pounds or more in 3 days.

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