The nurse is preparing an older client for a magnetic resonance imaging (MRI) with contrast. Which laboratory value should the nurse report to the healthcare provider before the scan is performed?
Reference Range:
Glycosylated hemoglobin (A1C) [4% to 5.9%]
Creatinine [0.5 to 1.1 mg/dL (44 to 97 umol/L)]
Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]
Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]
Fasting blood sugar of 200 mg/dL (11.1 mmol/L).
Glycosylated hemoglobin A1c of 8%.
Blood urea nitrogen of 22 mg/dL (7.9 mmol/L).
Serum creatinine of 1.9 mg/dL (169 umol/L).
The Correct Answer is D
Choice A reason: Fasting blood sugar of 200 mg/dL (11.1 mmol/L) indicates hyperglycemia, which is a high level of glucose in the blood. It can be caused by diabetes mellitus, stress, infection, or medication. Hyperglycemia can cause symptoms such as thirst, hunger, frequent urination, fatigue, and blurred vision. However, it does not affect the safety or accuracy of MRI with contrast.
Choice B reason: Glycosylated hemoglobin A1c of 8% indicates poor glycemic control over the past three months. It can be caused by diabetes mellitus, chronic kidney disease, or hemoglobinopathy. Glycosylated hemoglobin A1c reflects the average blood glucose level over the lifespan of red blood cells, which is about 120 days. However, it does not affect the safety or accuracy of MRI with contrast.
Choice C reason: Blood urea nitrogen of 22 mg/dL (7.9 mmol/L) indicates mild azotemia, which is a high level of nitrogenous waste products in the blood. It can be caused by dehydration, high protein intake, gastrointestinal bleeding, or kidney impairment. Azotemia can cause symptoms such as nausea, vomiting, confusion, and lethargy. However, it does not affect the safety or accuracy of MRI with contrast.
Choice D reason: Serum creatinine of 1.9 mg/dL (169 umol/L) indicates moderate renal insufficiency, which is a reduced ability of the kidneys to filter and excrete waste products and fluids from the body. It can be caused by diabetes mellitus, hypertension, glomerulonephritis, or nephrotoxic drugs. Renal insufficiency can cause symptoms such as edema, anemia, electrolyte imbalance, and acidosis. It can also increase the risk of contrast-induced nephropathy, which is a sudden deterioration of kidney function after exposure to contrast media used for imaging studies such as MRI. Contrast-induced nephropathy can lead to acute kidney injury, dialysis requirement, or even death. Therefore, serum creatinine should be reported to the healthcare provider before MRI with contrast to assess the risk and benefit of the procedure and to take preventive measures such as hydration, medication adjustment, or alternative imaging modalities.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This is incorrect because the humoral immune response involves B cells that produce antibodies against specific antigens. However, AIDS affects the cellular immune response, which involves T cells that activate other immune cells and directly kill infected cells.
Choice B reason: This is correct because AIDS is caused by human immunodeficiency virus (HIV), which infects and destroys CD4+ T cells, also known as helper T cells. These cells are essential for initiating and regulating both humoral and cellular immunity. Without enough CD4+ T cells, the body cannot mount an effective response against pathogens, especially opportunistic infections that take advantage of a weakened immune system.
Choice C reason: This is incorrect because bone marrow suppression of white blood cells is not a direct consequence of AIDS. However, some drugs used to treat AIDS, such as zidovudine, may cause bone marrow suppression as a side effect.
Choice D reason: This is incorrect because exposure to multiple environmental infectious agents does not cause AIDS. However, people with AIDS are more susceptible to infections from various sources due to their impaired immune system.
Correct Answer is ["inhaled smoke"," respiratory problems"," initial fluid shifts"," electrolyte imbalance"]
Explanation
The client has inhaled smoke, which can cause respiratory problemssuch as airway obstruction, bronchospasm, and pulmonary edema. The client also has initial fluid shifts, which can lead to electrolyte imbalancesuch as hyponatremia, hyperkalemia, and metabolic acidosis.
Choice A: inhaled smoke - respiratory problems
This is a correct choice. Inhaled smoke can damage the respiratory system by causing inflammation, edema, and carbon monoxide poisoning.
Choice B: initial fluid shifts - electrolyte imbalance
This is a correct choice. Initial fluid shifts occur when fluid moves from the intravascular space to the interstitial space due to increased capillary permeability. This can result in electrolyte imbalance such as low sodium, high potassium, and low bicarbonate levels.
Choice C: increased cardiac output - high blood sodium levels
This is an incorrect choice. Increased cardiac output is not a condition that occurs in burn patients. High blood sodium levels are not a common finding in burn patients either. High blood sodium levels can occur due to dehydration or excessive sodium intake.
Choice D: decreased catecholamines - hypometabolism
This is an incorrect choice. Decreased catecholamines are not a finding in burn patients. Catecholamines are hormones that increase heart rate, blood pressure, and metabolism in response to stress. Burn patients have increased catecholamines due to pain and tissue injury. Hypometabolism is also not a condition that occurs in burn patients. Hypometabolism is a state of low metabolic rate that can occur due to starvation, hypothyroidism, or hypothermia. Burn patients have increased metabolism due to increased energy demands for wound healing and thermoregulation.
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