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
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.

Choice A rationale
Idiopathic vasospasm, or spontaneous constriction of the blood vessels, can cause myocardial ischemia. However, this is a relatively rare cause compared to atherosclerosis.
Choice B rationale
Atherosclerosis, a condition characterized by the buildup of fatty plaques in the arteries, is the most common cause of myocardial ischemia. These plaques can restrict blood flow to the heart muscle, leading to ischemia.
Choice C rationale
Venous emboli, or blood clots that form in the veins, typically do not cause myocardial ischemia. These clots are more likely to cause problems in the lungs (pulmonary embolism) if they travel through the bloodstream.
Choice D rationale
Arterial emboli from a heart valve can cause myocardial ischemia, but this is less common than atherosclerosis. These emboli, or blood clots, can block blood flow to the heart muscle if they travel through the bloodstream.