During progressive ambulation on the third day after a myocardial infarction, which sign indicates the client should not advance?

During progressive ambulation on the third day after a myocardial infarction, which sign indicates the client should not advance?

• A. Shortness of breath.
• B. Facial flushing.
• C. Heart rate increase of 10 beats/min.
• D. Systolic blood pressure increase of 10 mm Hg.

Answer: (A)

During progressive ambulation after a myocardial infarction, the key thing being assessed is whether the activity level is tolerable for the heart and lungs. Shortness of breath during activity shows the body isn’t meeting the increased demand and can signal insufficient cardiac output, possible ischemia, or developing congestive symptoms. That makes it the clear sign that you should not advance the level of ambulation and should pause for rest and reassessment, possibly reducing the workload.

A small increase in heart rate and a modest rise in systolic blood pressure are expected responses to light activity as the body pumps more blood to meet demand. Facial flushing can occur with exertion due to increased blood flow and isn’t by itself a reason to stop.

If dyspnea improves with rest and vitals stay stable, activity can be resumed at a lower level; if it persists or other alarming symptoms appear (chest pain, dizziness, faintness), notify the clinician and reassess.