A nurse is assessing a client who is to have IV urography. Which of the following data should indicate to the nurse that this procedure is contraindicated for this client?

History of claustrophobia

Presence of a metal rod in her tibia

Allergy to shellfish

Prescribed rosiglitazone

Answer and Explanation

The Correct Answer is C

Choice A reason: Claustrophobia may cause discomfort during imaging procedures like MRI, but IV urography typically does not involve enclosed spaces. It is not a contraindication, though anxiety management may be needed.

Choice B reason: The presence of a metal rod in the tibia is relevant for MRI procedures due to magnetic interference, but it does not affect IV urography, which uses X-ray and contrast dye.

Choice C reason: An allergy to shellfish is a red flag for IV urography because it may indicate a sensitivity to iodine-based contrast agents. These agents are commonly used in urography and can trigger severe allergic reactions in susceptible individuals. Pre-procedure screening for contrast allergies is essential.

Choice D reason: Rosiglitazone is a medication used to manage type 2 diabetes. While it has cardiovascular risks, it does not contraindicate IV urography. However, renal function should be monitored in diabetic patients undergoing contrast studies.

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Correct Answer is C

Explanation

Choice A reason: Impedance plethysmography is an older diagnostic method for detecting deep vein thrombosis (DVT) but is less commonly used today due to lower sensitivity and specificity compared to duplex ultrasound. It may be considered in certain settings but is not the first-line test.

Choice B reason: Cold therapy is contraindicated in suspected DVT. It can cause vasoconstriction and worsen symptoms. Warm compresses may be used in some cases for comfort, but only after diagnosis and under provider direction.

Choice C reason: Venous duplex ultrasound is the gold standard non-invasive diagnostic test for DVT. It combines traditional ultrasound with Doppler flow studies to visualize thrombus and assess blood flow, making it the most appropriate and widely used test in this scenario.

Choice D reason: Homan's sign (pain in the calf upon dorsiflexion of the foot) is no longer considered a reliable or safe diagnostic tool for DVT. It lacks sensitivity and specificity and may even risk dislodging a clot. It is not recommended in current clinical practice.

A. "Soon those shock waves will get rid of my gallstones." B. "I'll have a camera put down my throat so they can see my gallbladder." C. "They are going to examine my gallbladder and ducts." D. "They'll put medication into my gallbladder to dissolve the stones."

Correct Answer is C

Explanation

Choice A reason: This statement describes extracorporeal shock wave lithotripsy (ESWL), a procedure used to break up kidney stones or gallstones using sound waves. It is not related to an oral cholangiogram, which is a diagnostic imaging procedure.

Choice B reason: This statement refers to endoscopic retrograde cholangiopancreatography (ERCP), where a camera is inserted through the throat to visualize the biliary tree. An oral cholangiogram, however, involves ingestion of contrast dye followed by X-ray imaging.

Choice C reason: This statement accurately reflects the purpose of an oral cholangiogram. The procedure involves taking an oral contrast agent that concentrates in the bile, allowing radiographic visualization of the gallbladder and bile ducts to detect stones, strictures, or other abnormalities.

Choice D reason: This statement describes a therapeutic intervention such as gallstone dissolution therapy, which involves medications like ursodiol. It is not part of the oral cholangiogram procedure, which is purely diagnostic.

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A nurse is assessing a client who is to have IV urography. Which of the following data should indicate to the nurse that this procedure is contraindicated for this client?

Nursing Test Bank

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