A nurse cares for a client with diabetes mellitus who is ...

[shofmannx20]

A nurse cares for a client with diabetes mellitus who is prescribed metformin (Glucophage) and is scheduled for an intravenous urography. Which action should the nurse take first?
 
  a. Contact the provider and recommend discontinuing the metformin.
  b. Keep the client NPO for at least 6 hours prior to the examination.
  c. Check the client's capillary artery blood glucose and administer prescribed insulin.
  d. Administer intravenous fluids to dilute and increase the excretion of dye.

Question 2

A nurse cares for a client with a urine specific gravity of 1.018. Which action should the nurse take?
 
  a. Evaluate the client's intake and output for the past 24 hours.
  b. Document the finding in the chart and continue to monitor.
  c. Obtain a specimen for a urine culture and sensitivity.
  d. Encourage the client to drink more fluids, especially water.

[jxjsniuniu]

Answer to Question 1

ANS: A
Metformin can cause lactic acidosis and renal impairment as the result of an interaction with the dye. This drug must be discontinued for 48 hours before the procedure and not started again after the procedure until urine output is well established. The client's health care provider needs to provide alternative therapy for the client until the metformin can be resumed. Keeping the client NPO, checking the client's blood glucose, and administering intravenous fluids should be part of the client's plan of care, but are not the priority, as the examination should not occur while the client is still taking metformin.

Answer to Question 2

ANS: B
This specific gravity is within the normal range for urine. There is no need to evaluate the client's intake and output, obtain a urine specimen, or increase fluid intake.

[shofmannx20]

Thanks for the timely response, appreciate it

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