The nurse is caring for a client who is going to have an intravenous pyelogram (IVP) using a contrast medium. Which of the following assessments by the nurse are of the highest priority?
Ask whether the patient has any questions about the procedure.
Ask the patient to void before the procedure.
Check for an allergy to iodine or shellfish.
Assess the client's ability to remain still for the procedure.
The Correct Answer is C
Choice A reason: While it is important to address any questions the patient may have, it is not the highest priority before an IVP procedure.
Choice B reason: Asking the patient to void before the procedure is a standard practice, but it is not the highest priority. The bladder should be empty to allow for clear imaging, but this can be managed at the time of the procedure.
Choice C reason: Checking for an allergy to iodine or shellfish is the highest priority because the contrast medium used in an IVP can cause severe allergic reactions in patients with these allergies. This assessment must be done before administering the contrast to prevent potentially life-threatening complications.
Choice D reason: Assessing the client's ability to remain still is important for the quality of the images, but it is not as critical as ensuring the safety of the patient regarding potential allergic reactions.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: Lactated Ringer's solution does not provide the necessary glucose and may not be compatible with TPN.
Choice B reason: 0.45% sodium chloride (0.45% NaCl) is a hypotonic solution and does not provide adequate calories for a patient on TPN.
Choice C reason: 10% dextrose in water (D10W) is the appropriate choice as it provides a source of calories and prevents hypoglycemia until the next TPN bag is available.
Choice D reason: 5% dextrose in lactated Ringer's solution (D5LR) provides less dextrose than D10W and may not prevent hypoglycemia as effectively.
Correct Answer is C
Explanation
Choice A reason: Taking several deep breaths is not specifically related to the preparation for a renal system physical assessment. Deep breaths are more commonly associated with lung examination or to help the patient relax.
Choice B reason: Drinking several glasses of water before a renal assessment could potentially fill the bladder, which might interfere with palpation of the kidneys and make it uncomfortable for the patient.
Choice C reason: Emptying the bladder is the correct action before a renal system physical assessment. It allows for better palpation of the kidneys and other structures without the discomfort of a full bladder. It also prevents the possibility of the patient urinating involuntarily during the examination due to a full bladder.
Choice D reason: Providing a urine sample might be part of the overall renal assessment, but it is not necessary to do so immediately before the physical examination of the renal system. The sample can be collected at any time before or after the physical examination.
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