A client diagnosed with type II diabetes controlled with a biguanide medication and a history of liver disease is scheduled for a computed tomography (CT) scan with contrast medium of the abdomen to evaluate pancreatic function.
Which intervention should the nurse implement?

Administer a laxative to cleanse the bowel before the CT scan.

Administer the biguanide medication as scheduled.

Advise the client to fast for 24 hours before the CT scan.

Ensure the client is adequately hydrated before the CT scan.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Administering a laxative is not necessary for a CT scan of the abdomen with contrast. Laxatives are typically used for bowel preparation for procedures like colonoscopies.

Choice B rationale

Biguanide medications such as metformin should be held before and after the administration of contrast medium to prevent lactic acidosis, particularly in clients with liver disease.

Choice C rationale

Fasting for 24 hours is not required before a CT scan with contrast medium. Typically, clients are asked to fast for a few hours prior to the procedure.

Choice D rationale

Ensuring the client is adequately hydrated helps to protect kidney function and reduce the risk of contrast-induced nephropathy. Hydration is especially important for clients with a history of liver disease.

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Correct Answer is D

Explanation

Choice A rationale

A complete blood count (CBC) can provide general information about the body's response to an MI, such as white blood cell count, but it is not definitive for diagnosing an MI.

Choice B rationale

A lipid profile measures cholesterol levels and helps assess cardiovascular risk, but it is not useful for diagnosing an acute MI.

Choice C rationale

An electrocardiogram (ECG) is essential for diagnosing an MI as it shows the heart's electrical activity and can indicate ischemia or infarction.

Choice D rationale

Troponin levels are the most specific and sensitive markers for myocardial infarction. Elevated troponin levels confirm heart muscle damage due to an MI, making it the definitive test.

Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A"}

Explanation

The client is at risk for developing Hyponatremia due to dehydration and hypovolemia. This risk may result in Confusion.

Choice A rationale: Hypernatremia is a condition characterized by high sodium levels in the blood. It typically results from water loss exceeding sodium loss, such as in cases of inadequate water intake, excessive sweating, or osmotic diuresis. Symptoms can include thirst, irritability, confusion, and muscle twitching. However, this client's presentation of dehydration and low blood pressure is more indicative of hyponatremia rather than hypernatremia.

Choice B rationale: Hyperkalemia refers to elevated potassium levels in the blood. This condition can occur due to kidney dysfunction, excessive potassium intake, or certain medications. Symptoms of hyperkalemia include muscle weakness, fatigue, numbness, and irregular heart rhythms. While dehydration can impact electrolyte levels, the client's presentation does not specifically suggest hyperkalemia.

Choice C rationale: Hypercalcemia is a condition where calcium levels in the blood are elevated. It can result from hyperparathyroidism, certain cancers, excessive calcium or vitamin D intake, or prolonged immobilization. Symptoms include nausea, vomiting, constipation, abdominal pain, and confusion. The client's symptoms do not align with hypercalcemia, as dehydration and hypovolemia are not primary causes of elevated calcium levels.

Choice D rationale: Hyponatremia occurs when sodium levels in the blood are abnormally low. This can result from excessive fluid loss, such as through vomiting, diarrhea, sweating, or inadequate sodium intake. Symptoms include headache, nausea, vomiting, confusion, seizures, and coma. Given the client's dehydration, low blood pressure, and symptoms of weakness and dizziness, hyponatremia is the most likely risk.

Options for Response 2:

Choice A rationale: Confusion is a common symptom of hyponatremia due to the brain's response to low sodium levels, which affects neuron function and water balance within brain cells. As sodium levels fall, osmotic imbalances cause cerebral edema, leading to altered mental status, lethargy, and confusion.

Choice B rationale: Seizures can occur in severe cases of hyponatremia when the brain's neurons are significantly impacted by osmotic shifts. However, the client's symptoms do not indicate imminent seizure activity, making confusion the more appropriate choice for this scenario.

Choice C rationale: Nausea and vomiting can be symptoms of hyponatremia but are not specific enough to be the primary concern here. The client's symptoms of confusion and lethargy take precedence due to their more direct impact on overall neurological function.

Choice D rationale: Abdominal cramps can result from various electrolyte imbalances, including hyponatremia. However, this symptom is less critical compared to the neurological implications of hyponatremia, such as confusion.

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A client diagnosed with type II diabetes controlled with a biguanide medication and a history of liver disease is scheduled for a computed tomography (CT) scan with contrast medium of the abdomen to evaluate pancreatic function.Which intervention should the nurse implement?

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Explanation

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A client diagnosed with type II diabetes controlled with a biguanide medication and a history of liver disease is scheduled for a computed tomography (CT) scan with contrast medium of the abdomen to evaluate pancreatic function.
Which intervention should the nurse implement?