A nurse is reviewing the chart of a client who is scheduled to have radiological studies of the kidneys performed with the use of IV contrast dye. Which of the following client medications should the nurse withhold prior to the examination?

Pantoprazole

Simvastatin

Valsartan

Metformin

Answer and Explanation

The Correct Answer is D

A) Pantoprazole:
Pantoprazole is a proton pump inhibitor used to reduce stomach acid. It does not typically require withholding before radiological studies with IV contrast dye.

B) Simvastatin:
Simvastatin, a statin medication used to lower cholesterol, does not need to be withheld before radiological studies with IV contrast dye.

C) Valsartan:
Valsartan, an angiotensin II receptor blocker used for hypertension, does not typically need to be withheld before radiological studies with IV contrast dye.

D) Metformin:
Metformin, an oral antidiabetic medication, should be withheld before radiological studies with IV contrast dye. There is a risk of lactic acidosis when metformin interacts with IV contrast dye, particularly in clients with impaired renal function.

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Correct Answer is D

Explanation

A) Activated partial thromboplastin time (aPTT): This test is primarily used to monitor the effectiveness of heparin therapy, not warfarin. While aPTT measures the intrinsic pathway of coagulation, it is not the standard test for monitoring warfarin, which affects the extrinsic pathway and vitamin K-dependent clotting factors.

B) Platelet count: This test measures the number of platelets in the blood and is used to diagnose and monitor conditions related to platelet function, such as thrombocytopenia. However, it does not provide information about the anticoagulant effect of warfarin, which works by inhibiting vitamin K-dependent clotting factors.

C) White blood cell count (WBC): This test measures the number of white blood cells in the blood and is used to diagnose and monitor infections and inflammatory conditions. It is not relevant for monitoring the anticoagulant effect of warfarin, as WBC levels are not influenced by warfarin therapy.

D) Prothrombin time (PT): This is the correct test to monitor the effect of warfarin therapy. PT measures the extrinsic pathway of coagulation, which is directly influenced by warfarin. The international normalized ratio (INR) is derived from the PT and is used to standardize PT results, making it the most reliable indicator of warfarin’s anticoagulant effect. Regular monitoring of PT/INR helps ensure therapeutic levels are maintained while minimizing the risk of bleeding complications.

A. "Apply the ointment in a thin line into the conjunctival sac." B. "Keep your eye open for 30 sec after instilling the ointment." C. "Use a sterile glove and applicator to apply the antibiotic ointment." D. "Always wipe from the outer to the inner canthus when wiping away secretions.

Correct Answer is A

Explanation

A) "Apply the ointment in a thin line into the conjunctival sac":
Applying the antibiotic ophthalmic ointment in a thin line into the conjunctival sac ensures that the medication comes into direct contact with the infected area of the eye. This method facilitates optimal absorption and distribution of the medication to effectively treat bacterial conjunctivitis. Ensuring correct application technique helps prevent unnecessary wastage and ensures that the medication reaches its intended site, maximizing therapeutic benefits.

B) "Keep your eye open for 30 sec after instilling the ointment":
While keeping the eye open for a brief period after instilling the ointment can facilitate distribution, it is secondary to ensuring the correct placement of the medication into the conjunctival sac, where it can act directly on the infection.

C) "Use a sterile glove and applicator to apply the antibiotic ointment":
Using a sterile glove and applicator may not be routinely necessary for applying antibiotic ophthalmic ointment. Clean hands and ensuring the tip of the tube or applicator does not touch any surfaces can maintain appropriate hygiene and prevent contamination.

D) "Always wipe from the outer to the inner canthus when wiping away secretions":
While wiping secretions should be done gently to avoid irritation, the direction (outer to inner canthus) primarily aims to prevent spreading infection to the unaffected eye. It is important but not directly related to the technique of applying ophthalmic ointment.

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A nurse is reviewing the chart of a client who is scheduled to have radiological studies of the kidneys performed with the use of IV contrast dye. Which of the following client medications should the nurse withhold prior to the examination?

Nursing Test Bank

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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