A nurse is monitoring a client during an IV urography procedure. Which of the following client reports is the priority finding?
Metallic taste in mouth
Abdominal fullness
Feeling flushed and warm
Swollen lips
The Correct Answer is D
A. A metallic taste in the mouth is a common side effect of the contrast dye used in IV urography procedures and is not typically a cause for concern.
B. Abdominal fullness may occur due to the administration of fluids during the procedure and is not usually a priority finding unless it persists or is severe.
C. Feeling flushed and warm may be a transient reaction to the contrast dye and does not typically require immediate intervention unless accompanied by other symptoms.
D. Swollen lips could indicate an allergic reaction to the contrast dye, which can progress rapidly and potentially lead to a severe reaction such as anaphylaxis. This is the priority finding requiring immediate attention.
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Related Questions
Correct Answer is C
Explanation
A. While understanding HIPAA regulations is important, addressing the immediate inappropriate behavior takes precedence.
B. While directing the conversation to a private area is appropriate, stopping the discussion immediately is the priority.
C. The priority is to stop the discussion immediately to prevent further breach of confidentiality.
D. While informing about potential liability for breaching confidentiality is important, addressing the immediate behavior is the priority.
Correct Answer is A
Explanation
A.
A. A BMI of 20 falls within the healthy weight range for adults, indicating that the client's weight is appropriate for his height.
B. A BMI of 20 is not indicative of malnutrition. Malnutrition is typically associated with lower BMIs.
C. A BMI of 20 is not within the overweight range, as overweight is typically defined as a BMI between 25 and 29.9.
D. A BMI of 20 is not within the obesity range, as obesity is typically defined as a BMI of 30 or higher.
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