During a stress test on a treadmill, which observation by the nurse would necessitate immediate action?

Choice A rationale
Diltiazem does not increase the contractile force of the heart. In fact, it is classified as a negative inotrope, meaning it decreases the force of heart contractions.
Choice B rationale
While diltiazem can affect heart rhythm, it does not specifically reduce heart palpitations. Its primary effect is to slow the heart rate and relax the blood vessels.
Choice C rationale
Diltiazem is a calcium channel blocker used to manage cardiovascular conditions such as hypertension, chronic stable angina, atrial fibrillation, and Prinzmetal’s angina. It works by inhibiting the calcium influx into cardiac and vascular smooth muscle during depolarization. This results in vasodilation, or the widening of blood vessels, which can help decrease coronary artery spasms, a characteristic feature of Prinzmetal’s angina.
Choice D rationale
Diltiazem does not prevent the formation of plaque in the coronary arteries. It primarily acts to relax the blood vessels and slow the heart rate.

Choice A rationale
Recurring chest pain can be a symptom of a serious condition such as a heart attack, which can occur if a blood clot forms in a vein deep inside the body, breaks off, and travels to the heart.
This is a potential complication of Deep Vein Thrombosis (DVT) and other vascular issues. Therefore, it’s important for the nurse to inquire about recurring chest pain in a patient with a past history of DVT and other vascular issues.
Choice B rationale
A peptic ulcer is a sore that develops on the lining of the stomach, upper small intestine, or lower esophagus. While peptic ulcers can cause discomfort and other symptoms, they are not typically associated with DVT or other vascular issues. Therefore, while it’s always important for the nurse to have a complete understanding of a patient’s health history, inquiring about a peptic ulcer may not be directly relevant to a patient with a past history of DVT and other vascular issues.
Choice C rationale
An aneurysm is a bulge or ballooning in the wall of an artery. Aneurysms can occur in any artery in the body, and they can be life-threatening if they rupture or dissect (tear)3. While aneurysms can be associated with certain vascular diseases, they are not typically associated with DVT3. Therefore, while it’s important for the nurse to be aware of a patient’s complete health history, inquiring about an aneurysm may not be directly relevant to a patient with a past history of DVT.
Choice D rationale
Rheumatoid arthritis is an autoimmune disease that causes inflammation in the joints. While it can cause a variety of symptoms and complications, it is not typically associated with DVT or other vascular issues. Therefore, while it’s always important for the nurse to have a complete understanding of a patient’s health history, inquiring about rheumatoid arthritis may not be directly relevant to a patient with a past history of DVT and other vascular issues.