Which of the following is most important for the nurse to include with calcium channel blockers?

Choice A reason: This choice is incorrect because glargine is not a drug that needs to be assessed before a CT scan with contrast. Glargine is a long-acting insulin that lowers blood sugar levels in people with diabetes. It is injected once a day, usually at bedtime, and works for 24 hours. The nurse should monitor the client's blood sugar levels and adjust the dose of glargine as needed, but it does not interfere with the CT scan or the contrast dye.

Choice B reason: This choice is correct because metformin is a drug that needs to be assessed before a CT scan with contrast. Metformin is an oral medication that lowers blood sugar levels in people with diabetes. It works by reducing the amount of glucose produced by the liver and increasing the sensitivity of the cells to insulin. However, metformin can cause a rare but serious condition called lactic acidosis, which is a buildup of lactic acid in the blood that can cause symptoms such as nausea, vomiting, abdominal pain, muscle weakness, and breathing problems. The risk of lactic acidosis is increased when metformin is combined with contrast dye, which can affect the kidney function and the clearance of metformin from the body. The nurse should check the client's kidney function and the dose and timing of metformin before the CT scan. The nurse should also instruct the client to stop taking metformin before and after the CT scan, as directed by the provider.

Choice C reason: This choice is incorrect because famotidine is not a drug that needs to be assessed before a CT scan with contrast. Famotidine is an antacid that reduces the amount of acid in the stomach. It is used to treat conditions such as gastroesophageal reflux disease (GERD), ulcers, and gastritis. It does not affect the blood sugar levels or the kidney function, and it does not interact with the contrast dye. The nurse should administer famotidine as prescribed and monitor the client's gastrointestinal symptoms, but it does not require any special precautions before the CT scan.

Choice D reason: This choice is incorrect because glucagon is not a drug that needs to be assessed before a CT scan with contrast. Glucagon is a hormone that raises blood sugar levels in people with diabetes. It is used as an emergency treatment for severe hypoglycemia (low blood sugar), when the person is unconscious or unable to swallow. It is injected into a muscle or under the skin, and it works by stimulating the liver to release glucose into the blood. The nurse should have glucagon available in case of hypoglycemia, but it does not affect the CT scan or the contrast dye.

Choice A reason: This choice is correct because captopril is an angiotensin-converting enzyme (ACE) inhibitor that can cause fetal harm or death if used during pregnancy. Captopril can affect the development of the baby's kidneys, lungs, skull, and blood vessels. The nurse should advise the patient to use effective contraception while taking captopril and to inform the provider as soon as possible if she becomes pregnant or plans to become pregnant. The provider may switch the patient to a safer medication for blood pressure control during pregnancy.

Choice B reason: This choice is incorrect because facial swelling is a serious side effect of captopril that may indicate angioedema, a life-threatening allergic reaction that causes swelling of the face, lips, tongue, throat, or airway. The nurse should instruct the patient to stop taking captopril and seek emergency medical attention if she develops facial swelling or any signs of difficulty breathing, such as wheezing, stridor, or cyanosis. Reducing the dose of captopril will not prevent or treat angioedema.

Choice C reason: This choice is incorrect because captopril can be taken with or without food, depending on the patient's preference and tolerance. Food may decrease the absorption of captopril, but this effect is not clinically significant for most patients. The nurse should advise the patient to take captopril at the same time each day, preferably one hour before meals, to maintain consistent blood levels and effects.

Choice D reason: This choice is incorrect because captopril is unlikely to cause anaphylaxis, a severe and potentially fatal allergic reaction that involves multiple organ systems. Anaphylaxis can cause symptoms such as hives, itching, flushing, swelling, nausea, vomiting, diarrhea, abdominal pain, low blood pressure, fast heart rate, and shock. The nurse should instruct the patient to carry an epi pen only if she has a history of anaphylaxis or a severe allergy to another substance. .