The nurse is preparing a young adult, female patient for ...

[kwoodring]

The nurse is preparing a young adult, female patient for intravenous pyelogram (IVP). What are the priority actions by the nurse prior to this procedure? Select all that apply.
 
  a. Obtain an informed consent prior to the procedure.
  b. Ask whether the patient has an allergy to shellfish.
  c. Check laboratory results for serum BUN and creatinine.
  d. Encourage increased fluid intake prior to the procedure.
  e. Determine whether the patient has had a barium enema in the past 4 days.

Question 2

The nurse is caring for a patient with suspected kidney dysfunction. In reviewing the patient's home medication list, the nurse is most alerted to which medications? Select all that apply.
 
  a. Aspirin
  b. Gentamicin
  c. Estrogen
  d. Ibuprofen
  e. Insulin

[matt]

Answer to Question 1

A, B, C, E
An intravenous pyelogram (IVP) uses radiopaque contrast medium to visualize the kidneys, ureters, bladder, and renal pelvis. This test evaluates renal function by analyzing flow of contrast over time. Priority nursing care prior to the procedure includes the following:
 Obtaining a history of allergies, most specifically allergies to shellfish because the dye used is iodine based
 Ensuring a baseline BUN and creatinine level have been performed, as this test is contraindicated for patients who are in renal failure
 Ensuring that a signed consent form is on the chart because this is an invasive procedure
The nurse would not increase fluid intake prior to the procedure, but would instruct and maintain the patient on NPO status for 8 hours prior to the test. Postprocedure patients are encouraged to increase fluid intake, and the nurse will monitor for any possible reaction to the dye, such as rash, nausea, or hives. It is appropriate to inquire about a barium enema because barium contrast material and medication containing bismuth (e.g., Pepto-Bismol) in the 4 days prior to the test can affect the results.

Answer to Question 2

A, B, D
In caring for patients with kidney disease, the nurse is most alerted to medications that can be nephrotoxic. These medications include gentamicin and high-dose or long-term use of aspirin and ibuprofen. Estrogen is used to improve the blood flow to and thickness in urethral tissues. Estrogen is not FDA approved for treatment of stress incontinence, although it may be prescribed for other reasons. The nurse should not have concern regarding the use of insulin with respect to potential for kidney dysfunction.

[kwoodring]

Thanks for the timely response, appreciate it

[ktidd]

Excellent