Examkin

Question

Difficulty: EasyReduction of Risk Potential

A nurse is reviewing the medical record of a client who is scheduled for a computed tomography (CT) scan with intravenous (IV) iodinated contrast. Which finding is the most critical to report to the healthcare provider prior to the procedure?

  1. The client takes metformin for the management of type 2 diabetes mellitus.Answer
  2. B
    A baseline arterial blood gas (ABG) result reveals a pH of 7.41 and a PaO2 of 95 mm Hg.
  3. C
    The client reports a history of seasonal allergic rhinitis triggered by tree pollen.
  4. D
    The previous nurse documented palpating the client's abdomen before auscultating bowel sounds.

Answer

The client takes metformin for the management of type 2 diabetes mellitus.
IV iodinated contrast can cause acute kidney injury. If the kidneys are compromised by the contrast, metformin can accumulate in the body, leading to a life-threatening condition called lactic acidosis. Therefore, recognizing metformin use is the highest priority for risk reduction, and the medication must be temporarily discontinued.

Step-by-Step Solution

1
Analyze the planned procedure and its physiological risks.
The client is scheduled for a CT scan with IV iodinated contrast, which carries a known risk of acute kidney injury.
Identifying the primary physiological risk of the procedure helps determine which assessment findings are most relevant.
2
Evaluate each assessment finding for its potential to increase procedural risk.
Metformin interacts with IV contrast to cause lactic acidosis. The ABG is normal, a pollen allergy is not a contrast risk, and an incorrect assessment sequence is not a physiological threat.
Systematically ruling out safe or low-priority findings isolates the critical safety hazard.
3
Select the finding that requires immediate clinical intervention.
The use of metformin is the finding that must be reported to the provider immediately.
The provider must order metformin to be held before and after the scan to prevent life-threatening complications.

Key Concept

Reduction of Risk Potential: Diagnostic Testing Preparations
Rate this question

Topics

Reduction of Risk Potential

More questions from this topic