The nurse is caring for a client with weak pedal pulses, absent hair on bilateral legs, and a full-thickness wound on the right lateral malleolus with defined margins, including a minimal amount of serous exudate.

Which of the following interventions is contraindicated?

Choice A rationale
Sinus tachycardia at a rate of 110 beats/min is a normal response to exercise. During a stress test, the heart rate will naturally increase as the body’s demand for oxygen increases. A heart rate of 110 beats/min is within the expected range during moderate exercise.
Choice B rationale
An increase in blood pressure from 134/68 to 150/80 mm Hg is a normal response to exercise. During a stress test, blood pressure will naturally rise as the heart works harder to pump blood to the muscles. This increase is within the expected range during moderate exercise.
Choice C rationale
Feeling tired during a stress test on a treadmill is a normal response to exercise. Fatigue can occur as the body’s energy stores are used up during physical activity. However, if the patient reports extreme fatigue or other symptoms such as chest pain or shortness of breath, it may indicate a problem.
Choice D rationale
Inversion of T waves on the electrocardiogram during a stress test is a sign of myocardial ischemia, a condition in which the heart muscle is not getting enough oxygen. This could indicate the presence of significant coronary artery disease and is a finding that would necessitate immediate action.

Choice A rationale
Furosemide (Lasix) is a diuretic often used in the treatment of pulmonary edema to help remove excess fluid from the body. While it’s important to monitor the patient’s fluid and electrolyte balance, it’s not typically necessary to question this medication.
Choice B rationale
Captopril (Capoten) is an ACE inhibitor used to treat conditions like heart failure and high blood pressure. It can be beneficial in managing pulmonary edema by reducing the workload on the heart. It’s not typically necessary to question this medication.
Choice C rationale
Digoxin (Lanoxin) is a medication used to treat heart failure and atrial fibrillation. It’s important to question this medication before administration because digoxin has a narrow therapeutic index, meaning the difference between a therapeutic dose and a toxic dose is small. Therefore, it’s crucial to ensure the patient’s digoxin levels are within the therapeutic range before administering more of the medication.
Choice D rationale
Carvedilol (Coreg) is a beta-blocker used to treat high blood pressure and heart failure. While it’s important to monitor the patient’s blood pressure and heart rate, it’s not typically necessary to question this medication.