The nurse is administering medications to a client who is being evaluated for a brain malignancy. The client is scheduled for a CT scan with IV iodinated contrast the next morning. Which medication should the nurse clarify with the health care provider?

Question

The nurse is administering medications to a client who is being evaluated for a brain malignancy.  The client is scheduled for a CT scan with IV iodinated contrast the next morning.  Which medication should the nurse clarify with the health care provider?

Quizplus · Accepted Answer

A computed tomography (CT) scan is a noninvasive procedure that provides detailed x-ray images of the body. In some cases, iodinated contrast (eg, IV, PO) is administered during the CT scan to enhance visualization of blood vessels or certain organs. For clients with renal impairment, a potential complication of IV iodinated contrast is acute kidney injury (ie, contrast-induced nephropathy). Lactic acidosis is a severe complication of metformin, an antidiabetic medication. Administration of IV iodinated contrast to a client who takes metformin can cause an accumulation of metformin in the bloodstream, which increases the risk for lactic acidosis. As a result, many health care providers will discontinue metformin 24-48 hours before administration of IV contrast and restart the medication after 48 hours, when stable renal function is confirmed (Option C). (Options A, B, and D) Amlodipine is a calcium channel blocker commonly used to treat hypertension. Gabapentin is an anticonvulsant that is also used for neuropathic pain. Phenytoin is an anticonvulsant. None of these medications are known to interact with the iodinated contrast or worsen kidney injury. Therefore, these medications can be safely administered to the client who is scheduled to receive IV iodinated contrast. Educational objective: Iodinated contrast is commonly administered during computed tomography (CT) scans to enhance visualization of certain body structures. Clients who receive IV iodinated contrast while taking metformin are at increased risk for lactic acidosis; therefore, the health care provider may discontinue metformin 24-48 hours before administration of IV contrast and restart the medication after 48 hours.

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