What factor would contraindicate the use of propranolol (Inderal) in a 38-year-old obese African American patient with diabetes who is being evaluated for hypertension control?

Choice A rationale
Reducing the overall contractility of the heart muscle is not the primary reason for performing Coronary Artery Bypass Surgery (CABG)4. In fact, reducing the contractility of the heart muscle could potentially decrease the heart’s ability to pump blood effectively.
Choice B rationale
Reducing plaque buildup in the carotid artery is not the primary reason for performing CABG4. While plaque buildup in the carotid artery can lead to serious conditions such as stroke, CABG is specifically performed to bypass blocked coronary arteries, not carotid arteries.
Choice C rationale
Increasing the oxygen supply to the heart muscle is the primary reason for performing CABG4. When coronary arteries become blocked or narrowed due to plaque buildup, the heart muscle may not receive enough oxygen-rich blood. CABG is performed to create a new route, or bypass, around the blocked artery, which improves blood flow and oxygen supply to the heart muscle.
Choice D rationale
Increasing the myocardial workload is not the primary reason for performing CABG4. In fact, increasing the workload of the heart could potentially exacerbate heart disease and lead to complications such as heart failure.

Choice A rationale
Redness on both sides of the sternal incision could indicate a normal inflammatory response post-surgery or could be a sign of infection. However, it is not the most crucial observation to report in the context of a patient who has undergone coronary artery bypass grafting using a right radial artery graft.
Choice B rationale
Fine crackles heard at both lung bases could indicate fluid accumulation in the lungs, possibly due to heart failure or pneumonia. While this is a significant finding that requires further investigation, it is not the most crucial observation in this specific context.
Choice C rationale
Complaints of incisional chest pain are common after coronary artery bypass grafting. Pain management is an important part of post-operative care, but this symptom is not the most crucial to report in this context.
Choice D rationale
Pallor and weakness of the right hand could indicate compromised blood flow to the hand, which is a serious complication considering the right radial artery was used for the graft. This could lead to ischemia and tissue damage in the hand, thus it is the most crucial observation to report to the healthcare provider.