A nurse is reviewing the medical record of a client who has a prescription for intermittent heat therapy for a foot injury. Which of the following findings should the nurse identify as a contraindication for heat therapy?

Abdominal aortic aneurysm

Phlebitis

Osteoarthritis

Peripheral neuropathy

Answer and Explanation

The Correct Answer is D

A. Abdominal aortic aneurysm. While an abdominal aortic aneurysm is a serious vascular condition, it is not directly affected by localized heat therapy to an extremity such as the foot. However, heat should still be used cautiously near major vascular abnormalities.
B. Phlebitis. Heat therapy is often used to reduce inflammation and promote circulation in conditions like phlebitis. Although care must be taken, it is not an absolute contraindication and may actually be prescribed in some mild cases under supervision.
C. Osteoarthritis. Heat therapy is commonly used for osteoarthritis to relax muscles, improve joint mobility, and alleviate stiffness and discomfort. It is considered a beneficial and appropriate treatment modality for this condition.
D. Peripheral neuropathy. Clients with peripheral neuropathy may have impaired sensation, making them unable to detect excessive heat. This puts them at high risk for burns or thermal injury, making heat therapy a contraindication for safety reasons.

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Correct Answer is A

Explanation

A. Sensation of skin warmth. A warm or flushed sensation is common during cardiac catheterization, especially when contrast dye is injected. This is a normal and temporary response to the dye used in the procedure.
B. Increased salivation. Increased salivation is not a typical reaction during cardiac catheterization. It is not associated with the administration of contrast dye or catheter manipulation.
C. Numbness and tingling of the extremities. Numbness or tingling may indicate compromised circulation or nerve involvement, which is abnormal and should be reported immediately. It may suggest complications like arterial spasm or clot.
D. Headache. Headaches are not expected during a cardiac catheterization. If a headache occurs, especially a severe one, it should be evaluated further, as it could indicate a reaction or another complication.

A. "I will hang a new bag of TPN and IV tubing every 24 hours." B. "I will obtain the client's weight every other day." C. "I will monitor the client's blood glucose level every 8 hours." D. “I will increase the rate of the TPN infusion to ensure the correct amount is given."

Correct Answer is A

Explanation

A. "I will hang a new bag of TPN and IV tubing every 24 hours." This is the correct action. TPN solutions are high in glucose and lipids, which create an ideal environment for bacterial growth. Changing the bag and tubing every 24 hours reduces the risk of infection and sepsis, especially in clients with central lines.
B. "I will obtain the client's weight every other day." Weight should be monitored daily in clients receiving TPN to assess for fluid status, nutritional progress, and potential complications like fluid overload or retention.
C. "I will monitor the client's blood glucose level every 8 hours." Clients receiving TPN require more frequent glucose monitoring, typically every 4 to 6 hours, especially when therapy is initiated, due to the high dextrose content that can cause hyperglycemia.
D. “I will increase the rate of the TPN infusion to ensure the correct amount is given." TPN infusion rates should never be adjusted independently by a nurse. Changes must be made only with a provider’s order, as improper rate adjustments can lead to electrolyte imbalances, hyperglycemia, or fluid overload.

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A nurse is reviewing the medical record of a client who has a prescription for intermittent heat therapy for a foot injury. Which of the following findings should the nurse identify as a contraindication for heat therapy?

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