What complication should a nurse monitor for in a client who experienced a myocardial infarction within 48 hours?

In the context of a patient who has experienced a myocardial infarction (MI) within 48 hours, monitoring for ventricular tachycardia is particularly crucial due to the heightened risk of serious arrhythmias during this acute phase.

Following a myocardial infarction, particularly within the first couple of days, the heart muscle is often irritable and can develop electrical abnormalities. Ventricular tachycardia, a rapid heart rhythm originating from the ventricles, can lead to decreased cardiac output and potentially progress to more severe conditions like ventricular fibrillation or cardiac arrest. Early monitoring for this type of arrhythmia is essential because prompt recognition and intervention can significantly alter outcomes for the patient.

While chest pain is common post-MI, it may not indicate a new or worsening complication. Cardiogenic shock, characterized by a significant drop in cardiac output leading to inadequate perfusion, is another critical concern but tends to arise later or with significant heart failure exacerbations. Atrial fibrillation may present but is generally considered a less immediate threat compared to ventricular tachycardia in the early post-MI period. Hence, the focus on monitoring for ventricular tachycardia is warranted due to its potential to rapidly compromise the patient's stability.