48. A 76-year-old client with hypertension, type 2 diabetes, and a known allergy to seafood is scheduled for a cardiac catheterization. Which orders should a nurse recognize as appropriate for this client? Select all that apply.
48. A 76-year-old client with hypertension, type 2 diabetes, and a known allergy to seafood is scheduled for a cardiac catheterization. Which orders should a nurse recognize as appropriate for this client? Select all that apply.
. Administration of methylprednisolone (Solu-Medrol).
. Draw blood for a liver panel.
. Draw blood for a renal panel.
. Start NS IV at 125 mL/hr.
. Hold metformin (Glucophage).
Test-Taking Tip
Think safety first. Protect the kidneys.
Content Area: Geriatric, Endocrine; Integrated Process: Nursing Process, Analysis; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Therapeutic Procedures
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Answer 1 is correct because antihistamines (Solu-Medrol) may be ordered before the procedure because of the known allergy to seafood. Answer 2 is incorrect because the contrast dye in this procedure will have the greatest effect on the kidneys, not the liver. Answer 3 is correct because the client's age and history of diabetes combined with the nephrotoxic effects of the contrast dye may lead to acute renal failure. Answer 4 is correct because IV hydration is a key to preventing acute renal failure secondary to the contrast dye used during catheterization. Answer 5 is correct because metformin is excreted in the kidneys. If the client develops renal failure secondary to the contrast media, the drug will accumulate and the client may develop fatal lactic acidosis.