The nurse is preparing an older adult client for a magnetic resonance imaging (MRI) with contrast. Which laboratory value should the nurse report to the healthcare provider before the scan is performed?
Reference Range:
Glycosylated Hemoglobin (4% to 5.9% ]
Creatinine 10.6 to 1.2 mg/dL (53 to 106 μmol/L)]
Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]
Blood Urea Nitrogen [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]
Fasting blood sugar of 200 mg/dl. (11.1 mmol/L).
Serum creatinine of 1.9 mg/dl. (168 μmol/l)
Glycosylated hemoglobin of 8%.
Blood urea nitrogen of 22 mg/dL (7.9 mmol/L)
The Correct Answer is B
B. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. Elevated serum creatinine levels may indicate impaired kidney function. Since contrast agents can affect renal function, a serum creatinine level above the reference range should be reported to the healthcare provider before the MRI with contrast.
A. While elevated blood sugar levels may indicate diabetes or poor glycemic control, they are not directly related to kidney function or the risk of contrast-induced nephropathy. Therefore, this value is not the most pertinent for reporting before an MRI with contrast.
C. Glycosylated hemoglobin (HbA1c) reflects average blood glucose levels over the past two to three months and is used to assess long-term glycemic control in diabetes. While elevated HbA1c levels suggest poor diabetes management, they do not directly assess kidney function or the risk of contrast-induced nephropathy.
D. Blood urea nitrogen (BUN) levels reflect the amount of urea nitrogen in the blood and can indicate kidney function. Elevated BUN levels may suggest impaired renal function. However, an elevated serum creatinine is a more reliable marker for renal excretion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
C. The DASH eating plan emphasizes consumption of fruits, vegetables, low-fat dairy products, whole grains, lean proteins, and limited amounts of saturated fats, cholesterol, and sodium. Therefore, enjoying fat-free yogurt as an occasional snack food aligns with the principles of the DASH eating plan.
A. is a good practice for food safety but does not specifically indicate adherence to the DASH eating plan. The DASH plan encourages consumption of fruits and vegetables but does not require meticulous cleaning or peeling.
B. may be suitable for individuals with lactose intolerance but is not a specific requirement of the DASH eating plan. The DASH plan recommends low-fat or fat-free dairy products but does not specify lactose-free products.
D. The DASH plan encourages consumption of whole grains as part of a balanced diet and recommends incorporating whole grains such as whole wheat, brown rice, and oats.
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"}}
Explanation
Understanding;
"Making these changes will also help me avoid other chronic health conditions."
"If I have symptoms like increased thirst and urination, I should come in and get my blood sugar checked."
No understanding;
"If my fasting blood sugar is less than 100 mg/dL (5.6 mmol/L) next time, I can go back to my usual eating habits."
"I can never eat sugar again."
"If I make the changes we talked about, I will not get type 2 diabetes."
Understanding
Adherence to the DASH diet reduces the risk of diabetes mellitus as well as other conditions such as myocardial infarction, hypertension and stoke
Overt diabetes mellitus presents with polyuria and polydipsia due to osmotic diuresis- the presence of increased glucose excreted in the urine exert an osmotic pressure, drawing water into the urine and increasing its volume.
No understanding
Having a normal fasting blood glucose is a good finding. However, resumption of poor eating habits increases the risk of diabetes mellitus moving forward. Also, there are other diagnostic criteria foe diabetes mellitus apart form fasting blood glucose such as OGTT, HbA1c
It is okay for the client to consume unrefined sugar without increased risk of diabetes mellitus. Refined sugars, however, are not recommended.
Adhering to dietary changes lowers the risk of diabetes but does not eliminate it. Other factors including genetics play a role in the development of diabetes mellitus.
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