A nurse is teaching a group of clients about risk factors for developing atrial flutter. Which of the following clients should the nurse understand is at highest risk for developing atrial flutter?

Rationale: A. While stress can contribute to arrhythmias, it is not the highest risk factor for atrial flutter. Stress alone is less likely to trigger atrial flutter without underlying cardiac disease. B. The client who is recovering from a recent illness that caused vomiting and diarrhea – Electrolyte imbalances from vomiting and diarrhea can predispose to arrhythmias, but the risk is temporary and generally lower compared with structural heart disease. C. The client whose mother and uncle were diagnosed with this same condition – A family history increases susceptibility, but genetic predisposition alone is not the highest risk factor for atrial flutter. D. Structural heart disease, such as ischemic heart disease following a myocardial infarction (MI), is a major risk factor for developing atrial flutter because damaged atrial tissue can create abnormal electrical pathways that facilitate reentry circuits, leading to flutter.