A nurse is teaching a female client who has a new prescription for transdermal sumatriptan to treat migraine headaches. Which of the following instructions should the nurse include?

Choice A reason: Ask the client to blow his nose

Asking the client to blow his nose is not advisable in this situation. Blowing the nose can increase intracranial pressure and potentially worsen the condition by causing more cerebrospinal fluid (CSF) to leak or even lead to further complications. Therefore, this action should be avoided.

Choice B reason: Suction the nostril

Suctioning the nostril is also not recommended. This action can introduce infection and increase the risk of further complications. It is important to handle any potential CSF leak with care to prevent infection and other issues.

Choice C reason: Notify the physician

While notifying the physician is important, it is not the immediate first step. The nurse should first confirm whether the clear drainage is CSF. Once confirmed, notifying the physician would be the next appropriate step.

Choice D reason: Test the drainage for glucose

Testing the drainage for glucose is the correct first action. CSF contains glucose, so a positive glucose test would confirm that the drainage is indeed CSF. This is a critical step in diagnosing a CSF leak, which can occur with basal skull fractures. Confirming the presence of CSF will guide further medical interventions and management.

Choice A reason: The procedure will be cancelled if the urinalysis indicates the presence of red blood cells

This statement is incorrect. The presence of red blood cells in the urine does not necessarily cancel an intravenous pyelogram (IVP). The test is often used to diagnose conditions that might cause blood in the urine, such as kidney stones or tumors. Therefore, this statement does not accurately reflect the procedure’s protocol.

Choice B reason: You will be able to resume your regular diet as soon as the test is complete

This statement is correct. After an IVP, clients can typically resume their regular diet unless otherwise instructed by their healthcare provider. However, this is not the most critical piece of information for the client to understand about the procedure.

Choice C reason: High-frequency sound waves will be used to identify renal system structures

This statement is incorrect. An IVP uses X-rays and a contrast dye to visualize the urinary tract, not high-frequency sound waves. High-frequency sound waves are used in ultrasound imaging, which is a different diagnostic procedure.

Choice D reason: After the procedure, you will be encouraged to drink plenty of fluids

This statement is correct and important. After an IVP, clients are encouraged to drink plenty of fluids to help flush the contrast dye out of their system and reduce the risk of kidney damage. This is a crucial part of post-procedure care and should be emphasized to the client.