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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A reason:

Hypotension (low blood pressure), tachycardia (rapid heart rate), and lethargy are critical symptoms that can indicate a life-threatening condition such as shock or severe dehydration. Hypotension can lead to inadequate perfusion of vital organs, resulting in multi-organ failure if not promptly addressed1. Tachycardia is often a compensatory mechanism for hypotension, and lethargy indicates decreased cerebral perfusion. Immediate intervention is required to stabilize the patient’s condition and prevent further deterioration.

Choice B reason:

Dizziness with a headache rated 7/10 on the numeric scale is concerning but not immediately life-threatening. These symptoms could indicate a variety of conditions, such as migraine, vertigo, or even a mild concussion. While the patient should be assessed and treated, they do not present the same immediate risk as hypotension and tachycardia.

Choice C reason:

Abdominal pain, hypertension (high blood pressure), and constipation are symptoms that need medical attention but are not immediately life-threatening. Hypertension can lead to serious complications if left untreated, but it does not require the same urgent intervention as hypotension. Abdominal pain and constipation, while uncomfortable and potentially indicative of underlying issues, do not pose an immediate threat to life.

Choice D reason:

Febrile (fever), tachycardia, and vomiting are symptoms that suggest an infection or other acute illness. While these symptoms are concerning and need prompt evaluation, they do not pose the same immediate risk as hypotension and tachycardia. Fever and vomiting can lead to dehydration, but this typically develops over a longer period compared to the rapid deterioration seen with hypotension.

A. Instruct the patient to withhold any medication for diuretic therapy. B. Prepare to administer fluids 2 hours before the procedure for patients with renal dysfunction. C. Advise the patient to take all anticoagulants. D. Administer steroids if the patient has an allergy to iodine-based contrast. E. Ensure that the patient is NPO for a minimum of 2 hours before the procedure.

Correct Answer is ["A","C","D","E"]

Explanation

Choice A: Instruct the patient to withhold any medication for diuretic therapy.

Reason: Diuretics can lead to dehydration and electrolyte imbalances, which can complicate the cardiac catheterization procedure. Withholding diuretics helps to maintain fluid balance and reduce the risk of complications during the procedure

Choice B: Prepare to administer fluids 2 hours before the procedure for patients with renal dysfunction.

Reason: Administering fluids before the procedure helps to prevent contrast-induced nephropathy, especially in patients with renal dysfunction. Hydration helps to flush out the contrast material used during the procedure, reducing the risk of kidney damage.

Choice C: Advise the patient to take all anticoagulants.

Reason: This choice is incorrect. Patients are usually advised to withhold anticoagulants before a cardiac catheterization to reduce the risk of bleeding complications. The decision to continue or withhold anticoagulants should be based on a careful assessment of the patient’s risk of thromboembolism versus the risk of bleeding.

Choice D: Administer steroids if the patient has an allergy to iodine-based contrast.

Reason: Administering steroids is a common premedication strategy for patients with a known allergy to iodine-based contrast media. Steroids help to reduce the risk of an allergic reaction during the procedure.

Choice E: Ensure that the patient is NPO for a minimum of 2 hours before the procedure.

Reason: Ensuring that the patient is NPO (nothing by mouth) helps to reduce the risk of aspiration during the procedure. Typically, patients are advised to be NPO for 6-8 hours before the procedure, but a minimum of 2 hours is essential.

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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.

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Naxlex Comprehensive Predictor Exams

A new nurse is having a difficult time identifying which client should be seen first because they all seem important. The nurse preceptor helps and explains that the client with which of the following should be seen first?

Correct Answer is A

Explanation

In addition to assessing peripheral pulses and auscultating the patient’s heart and lung sounds, which action will be implemented by the nurse before a cardiac catheterization? Select all that apply. One, some, or all responses may be correct.

Correct Answer is ["A","C","D","E"]

Explanation

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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.