A nurse is caring for a client who is taking metformin (Glucophage) and is scheduled to undergo angiography using iodine-containing contrast dye. The nurse should identify that an interaction between metformin and the IV contrast dye increases the client's risk for which of the following conditions?
Hyperglycemia
Acute renal failure
Acute pancreatitis
Acute liver failure
The Correct Answer is B
A. Hyperglycemia: While metformin is used to manage blood glucose levels in clients with diabetes, its interaction with contrast dye does not directly lead to hyperglycemia. However, the risk for kidney injury, which can affect glucose regulation, is a concern.
B. Acute renal failure: This is correct. The combination of metformin and iodine-containing contrast dye increases the risk of acute renal failure, also known as contrast-induced nephropathy (CIN). This occurs because contrast agents can cause kidney damage, and metformin is excreted by the kidneys. If renal function is impaired, the buildup of metformin can lead to lactic acidosis.
C. Acute pancreatitis: While acute pancreatitis is a possible side effect of metformin in some individuals, the primary concern with iodine-containing contrast dye is renal failure, not pancreatitis.
D. Acute liver failure: Metformin is primarily metabolized by the kidneys, not the liver, and does not commonly cause liver failure. Renal failure is the more pressing concern with the use of contrast dye in clients taking metformin.
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Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}
Explanation
- Docusate sodium: This is a surfactant laxative that helps soften stools by allowing water and fats to penetrate the stool, making it easier to pass.
- Loperamide: This medication is an anti-diarrheal agent that works by slowing down gut movement, which helps reduce the frequency of diarrhea.
Correct Answer is B
Explanation
A. Hypothyroidism: This is incorrect. The client is taking levothyroxine (Synthroid) to treat hypothyroidism, and the symptoms described (diarrhea, weight loss, palpitations, heat intolerance) are more likely associated with excess thyroid hormone, not a lack of it.
B. Thyrotoxicosis: This is correct. The symptoms the client is experiencing—diarrhea, weight loss, palpitations, and heat intolerance—are classic signs of thyrotoxicosis, which occurs when there is an excess of thyroid hormone, possibly due to overtreatment with levothyroxine. These symptoms indicate that the thyroid hormone dose might need adjustment.
C. Addison's Disease: This is incorrect. Addison's disease is characterized by insufficient production of adrenal hormones and would typically manifest with symptoms such as fatigue, hypotension, and hyperpigmentation, not diarrhea or heat intolerance.
D. Cushing's Disease: This is incorrect. Cushing's disease is caused by excess cortisol and would typically result in symptoms such as weight gain, high blood pressure, and a round "moon" face, rather than the symptoms described in the question.
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