A client was admitted 3 days ago with a myocardial infarction and has developed pulmonary edema. The family is asking the nurse about the cause of pulmonary edema. The nurse shares with the family which of the following best explanations?
1. The cardiac muscle has been injured and is not able to efficiently pump the blood through the client's system, resulting in an increased pressure in the pulmonary system.
2. The pulmonary system was injured first due to hypoxia, which caused the heart attack.
3. The cardiac muscle is working too hard to push fluids through the pulmonary system and there is fluid excess as a result.
4. The pulmonary system has an excessive amount of fluid that has been building over the last several days and now the heart is no longer able to keep up with the demands.
The cardiac muscle has been injured and is not able to efficiently pump the blood through the client's system, resulting in an increased pressure in the pulmonary system.
Rationale: During an MI, the cardiac muscle is injured and is not able to efficiently pump blood through the system. This decrease in pumping action results in an increased pulmonary pressure, which causes fluid to fill the interstitial spaces. The other explanations are not correct because the pulmonary system did not cause the MI, the MI causes pulmonary edema; it is not that the cardiac muscle is working too hard, but instead it is not working as well as it used to; and the pulmonary fluid overload is a direct result of the MI, not building up over several days.
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