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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Arterial blood gases - Arterial blood gases are not typically assessed before initiating lithium carbonate therapy.
B. Total cholesterol - Total cholesterol levels are not specifically relevant to monitoring lithium therapy.
C. Thyroid hormones - Thyroid function should be assessed before initiating lithium therapy because lithium can affect thyroid function, potentially leading to hypothyroidism.
D. Hemoglobin - While hemoglobin levels may be monitored during lithium therapy, they are not typically assessed prior to initiating treatment.
Correct Answer is A
Explanation
A.
A. Hallucinations - Delirium can cause perceptual disturbances such as hallucinations, where the client perceives things that are not actually present.
B. Agnosia - Agnosia refers to the inability to recognize familiar objects, which is not typically associated with delirium.
C. Bradycardia - Delirium is not typically associated with bradycardia; it may actually be associated with tachycardia due to the physiological stress response.
D. Aphasia - Aphasia refers to the loss of ability to understand or express speech, which is not typically associated with delirium.
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