A nurse is preparing to administer dabigatran to a client who has atrial fibrillation. The nurse should explain that the purpose of this medication is which of the following?

Choice A: Carvedilol is not a medication that interacts with contrast material and places the client at risk for acute kidney injury. Carvedilol is a beta-blocker that lowers blood pressure and heart rate by blocking the effects of adrenaline on the heart and blood vessels. Carvedilol does not affect kidney function or contrast excretion, but it can cause hypotension, bradycardia, or heart failure in some clients.

Choice B: Nitroglycerin is not a medication that interacts with contrast material and places the client at risk for acute kidney injury. Nitroglycerin is a vasodilator that relaxes the smooth muscles of the blood vessels and increases blood flow to the heart. Nitroglycerin does not affect kidney function or contrast excretion, but it can cause hypotension, headache, or flushing in some clients.

Choice C: Atorvastatin is not a medication that interacts with contrast material and places the client at risk for acute kidney injury. Atorvastatin is a statin that lowers cholesterol levels by inhibiting an enzyme that produces cholesterol in the liver. Atorvastatin does not affect kidney function or contrast excretion, but it can cause liver damage, muscle pain, or rhabdomyolysis in some clients.

Choice D: Metformin is a medication that interacts with contrast material and places the client at risk for acute kidney injury. Metformin is an oral antidiabetic drug that lowers blood glucose levels by decreasing hepatic glucose production and increasing insulin sensitivity. Metformin can accumulate in the kidneys and cause lactic acidosis, a life-threatening condition characterized by high levels of lactic acid in the blood. Contrast material can worsen kidney function and increase the risk of lactic acidosis in clients taking metformin. Therefore, metformin should be discontinued before and after the procedure as prescribed.

Choice a) is incorrect because calcium levels are not directly affected by hemodialysis. Calcium is a mineral that is important for bone health, blood clotting, and muscle contraction. Hemodialysis does not remove calcium from the blood, but it may cause low calcium levels if the dialysate fluid has a lower concentration of calcium than the blood.

Choice b) is correct because potassium levels are decreased by hemodialysis. Potassium is an electrolyte that is essential for nerve and muscle function, especially the heart. Hemodialysis removes excess potassium from the blood, which can build up in people with kidney failure and cause irregular heartbeats, muscle weakness, or even cardiac arrest.

Choice c) is incorrect because protein levels are not decreased by hemodialysis. Protein is a macromolecule that is composed of amino acids and performs various functions in the body, such as building and repairing tissues, transporting substances, and regulating processes. Hemodialysis does not remove protein from the blood, but it may cause low protein levels if the client has a poor diet or loses protein through other means, such as urine or wounds.

Choice d) is incorrect because RBC count is not decreased by hemodialysis. RBCs are red blood cells that carry oxygen throughout the body. Hemodialysis does not remove RBCs from the blood, but it may cause low RBC count if the client has anemia, which is a common complication of kidney failure. Anemia can be caused by reduced production of erythropoietin (a hormone that stimulates RBC production), iron deficiency, or blood loss.