A client with type II diabetes is scheduled to have a computed tomography (CT) scan with IV contrast of the brain to rule out a brain tumor. What health teaching would the nurse include?
Your provider will obtain a signed consent from you prior to the completion of the CT scan.
You’ll need to let your doctor know if you have seafood allergies.
Do not take your scheduled dose of Metformin 500 mg PO.
The procedure will be done at the bedside.
Take your Metformin as usual before the test.
The Correct Answer is B
Title: Choice A Reason:
Patients with seafood allergies may have a higher risk of allergic reactions to iodinated contrast media used in CT scans. However, this is not a definitive contraindication. The nurse should inform the patient to notify their healthcare provider about any known allergies, including seafood, as a precautionary measure. This allows the healthcare team to take necessary steps to prevent any adverse reactions, such as premedication with antihistamines or corticosteroids.
Title: Choice B Reason:
Metformin is a common medication used to manage type II diabetes. When a patient is scheduled for a CT scan with IV contrast, it is crucial to withhold Metformin before the procedure. This is because the combination of Metformin and iodinated contrast can increase the risk of contrast-induced nephropathy (CIN) and lactic acidosis, a rare but serious condition. The general recommendation is to stop Metformin at the time of or prior to the procedure and withhold it for 48 hours after the procedure, resuming only after renal function has been re-evaluated and found to be normal.
Title: Choice C Reason:
CT scans, especially those requiring IV contrast, are typically performed in a radiology suite equipped with the necessary technology and medical personnel. Performing such a procedure at the bedside is uncommon and not standard practice due to the need for specialized equipment and immediate access to emergency care in case of adverse reactions. Therefore, this statement is incorrect.
Title: Choice D Reason:
Taking Metformin as usual before the test is not recommended due to the risk of lactic acidosis when combined with iodinated contrast. As previously mentioned, Metformin should be withheld before and after the procedure until renal function is confirmed to be normal. This precaution helps to prevent any potential complications associated with the interaction between Metformin and the contrast agent.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["E","F","G"]
Explanation
Choice A reason:
Hypertension is not typically associated with myxedema coma. Myxedema coma is characterized by severe hypothyroidism, which usually leads to low blood pressure (hypotension) rather than high blood pressure (hypertension). Therefore, hypertension is not a clinical manifestation that indicates progression to myxedema coma.
Choice B reason:
Restlessness is not a common symptom of myxedema coma. Patients with myxedema coma often present with lethargy, confusion, or even coma due to the severe slowing of metabolic processes. Restlessness is more commonly associated with hyperthyroidism or other conditions that increase metabolic activity.
Choice C reason:
An increased level of alertness is contrary to the symptoms of myxedema coma. Myxedema coma typically presents with decreased mental status, including confusion, stupor, or coma. Therefore, an increased level of alertness would not be indicative of progression to myxedema coma.
Choice D reason:
Tachycardia (rapid heart rate) is not a typical symptom of myxedema coma. Instead, myxedema coma is associated with bradycardia (slow heart rate) due to the severe hypothyroid state. Tachycardia is more commonly seen in hyperthyroid conditions.
Choice E reason:
Hypotension (low blood pressure) is a key clinical manifestation of myxedema coma. The severe hypothyroid state leads to decreased cardiac output and vascular resistance, resulting in hypotension. This is a critical sign that the nurse should recognize as indicative of progression to myxedema coma.
Choice F reason:
Bradycardia (slow heart rate) is another hallmark of myxedema coma. The decreased metabolic rate in severe hypothyroidism leads to a reduced heart rate. Recognizing bradycardia is essential in identifying the progression to myxedema coma.
Choice G reason:
Hypoventilation (reduced breathing rate) is a significant symptom of myxedema coma. The severe hypothyroid state can lead to respiratory depression, resulting in hypoventilation. This can further exacerbate the patient’s condition and requires immediate medical attention.
Choice H reason:
Hyperventilation (increased breathing rate) is not associated with myxedema coma. Patients with myxedema coma typically experience hypoventilation due to the severe slowing of metabolic processes. Hyperventilation would be more indicative of conditions that increase metabolic activity or respiratory drive.
Correct Answer is A
Explanation
Choice A: He is NPO until the speech-language pathologist performs a swallowing evaluation.
When a client is admitted with a stroke, especially one affecting the left side, there is a significant risk of dysphagia, or difficulty swallowing. This can lead to choking and aspiration, which can cause pneumonia and other complications. Therefore, it is crucial to keep the client NPO (nothing by mouth) until a speech-language pathologist can perform a thorough swallowing evaluation. This ensures that the client can safely swallow without the risk of aspiration. The speech-language pathologist will assess the client’s ability to swallow different textures and consistencies of food and liquids and provide recommendations for safe feeding.
Choice B: Be sure to sit him up when you are feeding him to make him feel more natural.
While sitting the client up during feeding is a good practice to reduce the risk of aspiration, it is not sufficient on its own for a client who has just had a stroke. Without a proper swallowing evaluation, feeding the client could still pose a significant risk. Therefore, this choice is not the most appropriate response.
Choice C: You may give him a full-liquid diet, but please avoid solid foods until he gets stronger.
A full-liquid diet might seem like a safer option, but it still poses a risk of aspiration if the client has dysphagia. Without a swallowing evaluation, it is not safe to assume that the client can handle even a full-liquid diet. Therefore, this choice is not appropriate.
Choice D: Just be sure to add some thickener in his liquids to prevent choking and aspiration.
Adding thickener to liquids can help some clients with dysphagia, but it is not a one-size-fits-all solution. The appropriate consistency of liquids should be determined by a speech-language pathologist after a swallowing evaluation. Therefore, this choice is not appropriate without a prior assessment.
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