When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client’s upper back and the client denies pain. Which action should the nurse take?

Choice A reason: Omeprazole is a proton pump inhibitor used to treat gastroesophageal reflux disease (GERD). While it is generally safe, it is not commonly associated with causing jaundice. Omeprazole can cause liver enzyme elevations in rare cases, but it is not a primary concern for drug-induced jaundice.

Choice B reason: Acetaminophen is known to cause hepatotoxicity, especially in high doses or with prolonged use. It is one of the most common causes of drug-induced liver injury, which can lead to jaundice. The nurse should notify the healthcare provider about the use of acetaminophen, as it is a likely culprit for the client’s jaundice.

Choice C reason: Captopril is an ACE inhibitor used to treat hypertension. While it can cause various side effects, it is not typically associated with causing jaundice. The primary concerns with captopril are related to renal function and electrolyte imbalances.

Choice D reason: Prednisone is a corticosteroid used to reduce inflammation in conditions like osteoarthritis. Although long-term use of corticosteroids can affect liver function, it is not commonly associated with causing jaundice. The nurse should still monitor liver function but focus on more likely causes.

Choice A reason:

A CT scan performed six months earlier does not typically require follow-up unless there were specific findings or complications from the previous scan. The timing of the previous scan is not a contraindication for a new CT scan with contrast. However, it is always good practice to review previous imaging results to compare and assess any changes.

Choice B reason:

Metformin hydrochloride is a medication used to manage type 2 diabetes mellitus. It is important to follow up on this information because metformin can interact with the contrast dye used in CT scans. The combination can increase the risk of lactic acidosis, a rare but serious complication. Therefore, it is crucial to assess kidney function and possibly withhold metformin before and after the procedure to reduce this risk.

Choice C reason:

A report of the client’s sobriety for the last five years is generally a positive aspect of their medical history and does not require follow-up in the context of a CT scan with contrast. Sobriety does not impact the safety or efficacy of the contrast dye used in the scan.

Choice D reason:

A metal hip prosthesis placed twenty years ago is relevant information but does not typically require follow-up before a CT scan. Unlike MRI, where metal implants can cause issues, CT scans are generally safe for patients with metal prostheses. However, the presence of metal can sometimes affect the quality of the images, so it is important for the radiologist to be aware of it.