A nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. Which of the following medications taken by the client interacts with contrast material and places the client at risk for acute kidney injury?

Carvedilol

Nitroglycerin

Atorvastatin

Metformin

Answer and Explanation

The Correct Answer is D

Choice A: Carvedilol is not a medication that interacts with contrast material and places the client at risk for acute kidney injury. Carvedilol is a beta-blocker that lowers blood pressure and heart rate by blocking the eﬀects of adrenaline on the heart and blood vessels. Carvedilol does not aﬀect kidney function or contrast excretion, but it can cause hypotension, bradycardia, or heart failure in some clients.

Choice B: Nitroglycerin is not a medication that interacts with contrast material and places the client at risk for acute kidney injury. Nitroglycerin is a vasodilator that relaxes the smooth muscles of the blood vessels and increases blood ﬂow to the heart. Nitroglycerin does not aﬀect kidney function or contrast excretion, but it can cause hypotension, headache, or ﬂushing in some clients.

Choice C: Atorvastatin is not a medication that interacts with contrast material and places the client at risk for acute kidney injury. Atorvastatin is a statin that lowers cholesterol levels by inhibiting an enzyme that produces cholesterol in the liver. Atorvastatin does not aﬀect kidney function or contrast excretion, but it can cause liver damage, muscle pain, or rhabdomyolysis in some clients.

Choice D: Metformin is a medication that interacts with contrast material and places the client at risk for acute kidney injury. Metformin is an oral antidiabetic drug that lowers blood glucose levels by decreasing hepatic glucose production and increasing insulin sensitivity. Metformin can accumulate in the kidneys and cause lactic acidosis, a life-threatening condition characterized by high levels of lactic acid in the blood. Contrast material can worsen kidney function and increase the risk of lactic acidosis in clients taking metformin. Therefore, metformin should be discontinued before and after the procedure as prescribed.

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Correct Answer is B

Explanation

Choice A Reason: This is incorrect because a decreased level of consciousness is a late sign of shock, not an early one. Decreased level of consciousness indicates that the brain is not receiving enough oxygen and blood ﬂow, which can lead to irreversible damage and death.

Choice B Reason: This is correct because increased respiratory rate is an early sign of shock, indicating hypoxia. This finding indicates that the client is experiencing hypoxia, which is a lack of oxygen in the tissues and organs. Hypoxia is a common and early sign of shock, which is a condition where the body's vital organs do not receive enough blood

ﬂow and oxygen due to low blood pressure, low cardiac output, or low blood volume. The client's respiratory rate increases as a compensatory mechanism to increase oxygen intake and delivery.

Choice C Reason: This is incorrect because hypotension is a late sign of shock, not an early one. Hypotension indicates that the blood pressure is too low to maintain adequate perfusion and oxygenation to the vital organs.

Choice D Reason: This is incorrect because anuria is a late sign of shock, not an early one. Anuria indicates that the kidneys are not receiving enough blood ﬂow and oxygen, which can result in acute kidney injury or failure.

A. Attach the leads for a 12-lead ECG. B. Initiate oxygen therapy. C. Insert the IV catheter. D. Obtain a blood sample.

Correct Answer is B

Explanation

The correct answer is: B. Initiate oxygen therapy.

Choice A reason:

Attaching the leads for a 12-lead ECG is crucial for diagnosing a myocardial infarction. However, it is not the first priority. Ensuring the patient receives adequate oxygen is more critical to prevent further myocardial damage. The ECG can be performed immediately after oxygen therapy is initiated to confirm the diagnosis and guide further treatment.

Choice B reason:

Initiating oxygen therapy is the first priority because it ensures that the heart muscle receives adequate oxygen, which is essential to prevent further damage during a myocardial infarction. Oxygen therapy helps to maintain tissue oxygenation and can reduce the extent of myocardial injury. This immediate intervention is vital to stabilize the patient and improve outcomes.

Choice C reason:

Inserting the IV catheter is important for administering medications and fluids. However, it is not the first step. Oxygen therapy takes precedence to ensure the heart and other vital organs receive sufficient oxygen. Once oxygen is administered, IV access can be established to facilitate further treatment.

Choice D reason:

Obtaining a blood sample is necessary for confirming the diagnosis and assessing cardiac markers. However, it is not the immediate priority. Ensuring the patient is oxygenated is more urgent to prevent further myocardial damage. Blood samples can be drawn after oxygen therapy is initiated.

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A nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. Which of the following medications taken by the client interacts with contrast material and places the client at risk for acute kidney injury?

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