Mr. Wagner, 68, suddenly develops chest pain radiating to the left arm 5 days after a mild myocardial infarction. What should the nurse do first?

• A. Call family
• B. Reassure and wait
• C. Obtain ECG and report client pain to physician
• D. Transfer to ICU

Answer: (C)

New chest pain after a myocardial infarction is a medical emergency. The priority is to assess the heart immediately to determine if there is reinfarction or another ischemic complication. An ECG is the fastest, most informative test to detect current ischemia, arrhythmias, or new infarction changes. By obtaining an ECG right away and notifying the physician, you enable rapid decisions about treatment (medications, monitoring needs, possible interventions). Delaying for reassurance, waiting, or routing actions to family does not address the immediate risk. Moving to ICU depends on the patient’s status after the initial assessment, but you can’t determine that without the ECG data and physician input.