In the case of a patient with COPD and recent myocardial infarction, which nursing concern is most relevant?

In a patient with Chronic Obstructive Pulmonary Disease (COPD) who has also experienced a recent myocardial infarction, the primary nursing concern should focus on alteration in gas exchange. COPD inherently involves compromised lung function, which affects the ability to effectively exchange oxygen and carbon dioxide. With the added stress of myocardial infarction, the patient's respiratory capability can be further diminished, potentially leading to hypoxemia and respiratory distress.

In this context, maintaining adequate oxygenation becomes crucial. Health care providers need to monitor respiratory rates, oxygen saturation levels, and overall respiratory effort to prevent further complications. Interventions may include administering supplemental oxygen, positioning the patient for optimal breathing, and closely observing for signs of respiratory failure.

While other concerns such as knowledge deficit, acute discomfort, and alteration in skin integrity are important to address, the immediate and most critical aspect for a patient with COPD and recent myocardial infarction is ensuring adequate gas exchange to support both pulmonary and cardiac function. Prioritizing this ensures that the multifaceted needs of the patient are met, particularly in managing their respiratory status effectively.