A nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. Which of the following medications taken by the client interacts with contrast material and places the client at risk for acute kidney injury?

Choice A Reason:

A rosebud-like stoma orifice is a normal finding for a newly created colostomy. This appearance indicates that the stoma is healthy and well-formed. The stoma should protrude slightly from the abdomen and have a pink or red color, similar to the inside of the mouth. This indicates good blood flow and proper healing. Therefore, a rosebud-like stoma orifice does not need to be reported to the provider.

Choice B Reason:

A stoma oozing red drainage can be concerning, but it is not uncommon for a new stoma to have some minor bleeding or oozing, especially in the immediate postoperative period. This can occur due to the delicate nature of the tissue and the recent surgical intervention. However, if the drainage is excessive or persistent, it should be monitored closely and reported if it does not improve. Minor oozing is generally expected and does not necessarily indicate a serious problem.

Choice C Reason:

A shiny, moist stoma is a normal finding and indicates that the stoma is healthy. The stoma should be moist and have a shiny appearance, similar to the inside of the mouth. This moisture is necessary for the proper function and health of the stoma. Therefore, a shiny, moist stoma does not need to be reported to the provider.

Choice D Reason:

A purplish-colored stoma is an abnormal finding and should be reported to the provider immediately. This discoloration can indicate compromised blood flow to the stoma, which can lead to tissue necrosis if not addressed promptly. A healthy stoma should be pink or red, indicating good blood circulation. Any deviation from this color, especially a purplish or dark color, is a sign of potential ischemia or other serious complications that require immediate medical attention.

Choice A Reason:

Place the client on aspiration precautions: Myxedema coma is a severe form of hypothyroidism that can lead to decreased mental function and a reduced level of consciousness. These conditions increase the risk of aspiration, which can lead to pneumonia and other complications. Therefore, placing the client on aspiration precautions is crucial to prevent these risks. Aspiration precautions may include elevating the head of the bed, monitoring swallowing ability, and providing thickened liquids if necessary.

Choice B Reason:

Turn the client every 4 hours: While turning the client regularly is important to prevent pressure ulcers, it is not the primary action needed for a client in a myxedema coma. The focus should be on stabilizing the client’s condition and preventing life-threatening complications such as aspiration, respiratory failure, and cardiovascular collapse.

Choice C Reason:

Check the client’s blood pressure every 2 hours: Monitoring vital signs, including blood pressure, is essential for clients in a myxedema coma. However, it is not the most critical action compared to preventing aspiration. Blood pressure should be monitored regularly, but the frequency can be adjusted based on the client’s condition and stability.

Choice D Reason:

Initiate measures to cool the client: Clients in a myxedema coma typically present with hypothermia (low body temperature), not hyperthermia (high body temperature). Therefore, initiating measures to cool the client would be inappropriate and could worsen their condition. Instead, measures to warm the client, such as using blankets and adjusting room temperature, are more appropriate.