A nurse is providing discharge instructions to a client who has pulmonary tuberculosis and a new prescription for rifampin.
Which of the following information should the nurse provide?

Choice A rationale:

The client stating, “I haven’t had anything to eat or drink since last night” is not a cause for concern. This is because patients are often advised to fast before undergoing certain medical procedures or tests, including an intravenous pyelogram (IVP).

Fasting helps to ensure that the test results are accurate and not influenced by recent food or drink consumption.

Choice B rationale:

The client expressing that “The last time I voided it was painful” could be related to their recurrent kidney stones. Kidney stones can cause discomfort or pain during urination. However, this statement does not necessarily require additional data collection in the context of an IVP. The pain could be a symptom of the kidney stones rather than a contraindication for the IVP1.

Choice C rationale:

The statement “I took my metformin before breakfast” is of concern. Metformin is a medication used to treat type 2 diabetes. It is important for the nurse to collect additional data about this statement because metformin can potentially interact with the iodine-based contrast dye used in an IVP. This interaction can increase the risk of lactic acidosis, a serious and potentially lifethreatening condition. Therefore, patients are often advised to stop taking metformin before and for a couple of days after having an IVP12. Choice D rationale:

The client mentioning, “I took a laxative yesterday” is not necessarily alarming. Laxatives are often used before an IVP to clear the bowels, which helps to ensure clear images during the procedure. Therefore, this statement does not require additional data collection in the context of an IVP1.

Choice A rationale:

Constipation is not typically associated with hyperthyroidism. In fact, one of the symptoms of hyperthyroidism is increased bowel movement. This is due to the increased metabolic rate caused by the overproduction of hormones from the thyroid gland.

Choice B rationale:

Weight gain is not a common symptom of hyperthyroidism. On the contrary, weight loss is one of the symptoms of this condition. This is because hyperthyroidism speeds up the body’s metabolism, causing increased calorie burning and significant weight loss. Choice C rationale:

Sensitivity to cold is not a symptom of hyperthyroidism. Instead, individuals with hyperthyroidism often have an increased sensitivity to heat. This is due to the increased metabolic rate which can cause excessive sweating and hot flashes.

Choice D rationale:

Frequent mood changes are a common symptom of hyperthyroidism. The overproduction of hormones by the thyroid gland can lead to symptoms such as irritability and restlessness. Additionally, other symptoms such as difficulty sleeping can also contribute to mood changes.