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 F
Explanation
Assessment: Patient had 2 semi-formed bowel movements 1 hour after administration of the medication
Choice A Reason:
Assessment: Patient denies vomiting
This choice is not directly related to the effectiveness of Kayexalate. Vomiting can be a symptom of hyperkalemia, but the absence of vomiting does not indicate that the medication is working. Kayexalate works by binding potassium in the intestines and removing it through the stool, so the presence of bowel movements is a more direct indicator of its effectiveness.
Choice B Reason:
ECG: Flattening of QRS complex angle
Flattening of the QRS complex angle is not a typical ECG change associated with hyperkalemia or its treatment. Hyperkalemia typically causes widening of the QRS complex, and effective treatment would normalize this. Therefore, this choice is not correct.
Choice C Reason:
ECG: Widening of the QRS complex
Widening of the QRS complex is a sign of hyperkalemia, not its resolution. If the medication is effective, the QRS complex should return to a normal width. Therefore, this choice is not correct.
Choice D Reason:
Assessment: Patient consumed 60% of meal
While nutritional intake is important, it is not a direct indicator of the effectiveness of Kayexalate. The medication’s effectiveness is better assessed by changes in potassium levels and related symptoms, not by meal consumption.
Choice E Reason:
Assessment: Patient denies nausea
Similar to vomiting, nausea can be a symptom of hyperkalemia, but the absence of nausea does not indicate that the medication is working. The effectiveness of Kayexalate is better assessed by the presence of bowel movements and changes in potassium levels.
Choice F Reason:
Assessment: Patient had 2 semi-formed bowel movements 1 hour after administration of the medication
This is the correct answer. Kayexalate works by binding potassium in the intestines and removing it through the stool. The presence of bowel movements indicates that the medication is working to remove potassium from the body. This is a direct and relevant assessment finding.
Choice G Reason:
ECG: Shortening of P wave duration
Shortening of the P wave duration is not a typical ECG change associated with hyperkalemia or its treatment. Therefore, this choice is not correct.
Choice H Reason:
Assessment: Patient denies pain
Pain is not a typical symptom of hyperkalemia, and its absence does not indicate that the medication is working. Therefore, this choice is not correct.
Choice I Reason:
ECG: Reduction of T wave amplitude
Reduction of T wave amplitude can be a sign of hypokalemia, not hyperkalemia. Effective treatment of hyperkalemia would normalize the T wave amplitude, not reduce it. Therefore, this choice is not correct.
Correct Answer is ["C","D","E"]
Explanation
Choice A Reason:
Provide continued sedation.
Providing continued sedation is not typically necessary after a cardioversion. The sedation used during the procedure is usually short-acting, and the client should begin to wake up shortly after the procedure is completed. Continuous sedation is not required unless there are specific medical reasons, which should be determined by the healthcare provider.
Choice B Reason:
Remove crash cart from the room.
The crash cart should remain in the room until the client is fully stable. Removing it immediately after the procedure is not advisable because the client may still be at risk for complications such as arrhythmias or other cardiac events. Keeping the crash cart nearby ensures that emergency equipment is readily available if needed.
Choice C Reason:
Assess the chest for burns.
Assessing the chest for burns is an important nursing action following a cardioversion. The electrical shock delivered during the procedure can cause burns on the skin where the electrodes were placed. It is essential to check for any signs of burns or skin irritation and provide appropriate care if needed.
Choice D Reason:
Ensure electrodes are in place for continued monitoring.
Ensuring that the electrodes are in place for continued monitoring is crucial. Continuous cardiac monitoring is necessary to observe the client’s heart rhythm and detect any potential complications or recurrence of arrhythmias. Proper placement and function of the electrodes are essential for accurate monitoring.
Choice E Reason:
Document results of the procedure.
Documenting the results of the procedure is a critical nursing action. Accurate documentation includes noting the client’s response to the cardioversion, any complications, and the current heart rhythm. This information is vital for ongoing care and communication with the healthcare team.
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