Which of the following patients scheduled for an interventional ...

[s.tung]

Which of the following patients scheduled for an interventional radiology procedure requiring administration of radiocontrast dye would be considered at high risk for nephrotoxicity? Select all that apply.
 
  A)
  A 14-year-old with severe abdominal pain
  B)
  A 25-year-old with a history of glomerular nephritis who is complaining of severe flank pain
  C)
  A 67-year-old diabetic undergoing diagnostic testing for new-onset proteinuria
  D)
  A 45-year-old with elevated liver enzymes possibly due to fatty liver cirrhosis
  E)
  A 53-year-old male undergoing biopsy for a suspicious spot on his chest x-ray

Question 2

A patient with ESRD comes into the emergency department in severe acidosis. The nurse notes that the respiratory rate is 36 breaths/minute.
 
  The nurse understands the pathophysiology of this response and explains to the student nurse that the patient's
  A)
  anxiety level is high, and the body is trying to release endorphins.
  B)
  chemoreceptors in the carotid and aortic bodies have noticed the pH change and altered the ventilator rate.
  C)
  kidneys are not able to buffer the acid and require the help from the lungs.
  D)
  lungs are trying to excrete excess hydrogen.

[kingfahad97]

Answer to Question 1

Ans:
B, C

Feedback:

Radiocontrast media-induced nephrotoxicity is thought to result from direct tubular toxicity and renal ischemia. The risk for renal damage caused by radiocontrast media is greatest in older adults and those with preexisting kidney disease, volume depletion, diabetes mellitus, and recent exposure to other nephrotoxic agents.

Answer to Question 2

Ans:
B

Feedback:

The second line of defense against acid-base disturbances is the control of extracellular CO2 by the lungs. Blood PCO2 and pH are important regulators of ventilation. Chemoreceptors in the brain stem and the peripheral chemoreceptors in the carotid and aortic bodies sense changes in PCO2 and pH and alter the ventilatory rate.