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.
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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Related Questions
Correct Answer is D
Explanation
Choice A rationale
Administering packed RBCs is important but is not the highest priority. Stabilizing the client’s hemodynamic status is critical first.
Choice B rationale
Elevating the client's feet can help with blood circulation but does not address the immediate need to stabilize blood pressure and fluid volume.
Choice C rationale
Initiating a dopamine IV infusion can help with hypotension, but it is not the first action. Stabilizing the client with fluids is a higher priority.
Choice D rationale
Increasing the client's IV fluid rate is the highest priority to address hypotension and ensure adequate blood volume before administering blood products or other medications. .
Correct Answer is B
Explanation
Choice B rationale
Potassium levels should be reviewed before administering furosemide. Furosemide is a loop diuretic that can cause significant potassium loss through increased urine output. Monitoring potassium is crucial to prevent hypokalemia, which can lead to cardiac arrhythmias and other serious complications.
Choice A rationale
Bicarbonate levels are not directly impacted by furosemide use and are less critical to review in this context. While they are important in assessing acid-base balance, they are not the primary concern when administering furosemide.
Choice C rationale
Phosphate levels are not typically affected by furosemide and are not the main focus before administration. Monitoring phosphate might be important in other scenarios, but it is not directly relevant here.
Choice D rationale
Carbon dioxide levels are more relevant to respiratory function and acid-base balance but are not directly impacted by furosemide. The focus should be on monitoring electrolytes, particularly potassium, to prevent complications from diuretic therapy.
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