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Difficulty: EasyReduction of Risk Potential

A practical nurse is preparing a client for a scheduled computed tomography (CT) scan that requires the administration of intravenous contrast dye. The nurse is reviewing the client's electronic health record. Which of the following documented findings indicate an increased risk for complications and require immediate notification to the registered nurse? Select all that apply.

  1. A serum creatinine level of 2.8 mg/dLAnswer
  2. A documented history of anaphylaxis to iodineAnswer
  3. Current daily use of prescribed metforminAnswer
  4. D
    A serum potassium level of 4.1 mEq/L
  5. E
    A baseline blood pressure of 118/74 mm Hg

Answer

The findings that require immediate notification to the registered nurse are the elevated serum creatinine level, the documented iodine anaphylaxis, and the current use of metformin.
Intravenous contrast dye is primarily cleared by the kidneys and typically contains iodine. Therefore, renal impairment (evidenced by an elevated creatinine level) and a known iodine allergy are direct risks for nephropathy and anaphylaxis, respectively. Additionally, taking metformin concurrently with contrast dye significantly increases the risk of lactic acidosis, requiring the medication to be temporarily withheld.

Step-by-Step Solution

1
Analyze the physiological requirements of the scheduled procedure.
CT scans with contrast utilize intravenous iodine-based dye, which is subsequently excreted by the kidneys.
Understanding how the procedure impacts the body helps identify specific physiological risks and contraindications.
2
Evaluate the client's laboratory values and current medication list.
The elevated serum creatinine level indicates renal impairment, and the use of metformin carries a high risk for lactic acidosis when combined with contrast dye.
The nurse must identify any systemic findings that interfere with the safe excretion of the dye.
3
Review the client's documented allergy history.
An allergy to iodine is a direct and severe contraindication to the contrast dye used in the scan.
Preventing an anaphylactic reaction is a primary safety responsibility before any diagnostic procedure.

Key Concept

Identifying risk factors and contraindications prior to diagnostic procedures involving intravenous contrast dye.
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Topics

Reduction of Risk Potential

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