Final answer:
Digoxin is contraindicated when the apical pulse rate indicates bradycardia, which is below 60 bpm in adults. As digoxin can lower the heart rate, it should not be given if the apical pulse rate is already low to prevent further reduction and potential complications.
Step-by-step explanation:
The question pertains to the administration of the medication digoxin to adults with heart failure, and when it is contraindicated based on the apical pulse rate. Digoxin is prescribed to ease symptoms of heart failure and to slow down certain types of irregular heartbeats such as atrial fibrillation. It is important to monitor the apical pulse because giving digoxin when the heart rate is too low (bradycardia) can be dangerous.
For adults, a normal resting heart rate (HR) falls between 60 and 100 beats per minute (bpm). The condition known as bradycardia occurs when the resting HR drops below 60 bpm and could potentially be worsened by digoxin. Most patients do not experience symptoms and are considered to be asymptomatic if their HR remains above 50 bpm. If symptoms like weakness, fatigue, dizziness, or chest discomfort are present alongside bradycardia, it becomes clinically significant. In such cases, digoxin would not be administered to avoid further decreasing the heart rate and exacerbating the condition.