A diabetic client who is currently taking metformin is ordered a computerized tomography (CT) scan with contrast. The nurse understands that the client's metformin should be discontinued how many hours before receiving intravenous (IV) contrast?
24 hours
12 hours
6 hours
48 hours
The Correct Answer is B
A. Discontinuing metformin 24 hours before a CT scan is longer than necessary and not standard practice.
B. It is generally recommended that metformin be held for at least 12 hours before the administration of IV contrast to reduce the risk of lactic acidosis, especially in clients with renal impairment.
C. Six hours is insufficient time to ensure the medication is cleared from the system, considering the potential risks.
D. Discontinuing metformin for 48 hours is overly cautious and not necessary unless there are complications that arise after the contrast is administered.
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Correct Answer is ["D","E","F"]
Explanation
A. Excessive sweating is not typically associated with anticholinergic medications like scopolamine; in fact, these medications can lead to decreased sweating.
B. Bradycardia can occur with certain medications but is more commonly associated with other drug classes rather than scopolamine, which typically causes tachycardia.
C. Diarrhea is not a common side effect of scopolamine; instead, anticholinergics often cause constipation.
D. Urinary retention is a known side effect of scopolamine due to its anticholinergic properties, which can affect bladder function.
E. Constipation is a common side effect of anticholinergic medications, including scopolamine.
F. Dry mouth is another common side effect due to decreased salivary secretions resulting from anticholinergic activity.
Correct Answer is C
Explanation
A. Macrolides, such as azithromycin and erythromycin, have a low cross-reactivity with penicillin and are typically safe alternatives for those with penicillin allergies.
B. Sulfonamides are not structurally similar to penicillins and generally do not have cross-sensitivity issues with penicillin allergies.
C. Cephalosporins share a similar beta-lactam structure to penicillins, which can result in cross-sensitivity in some individuals with a penicillin allergy. For this reason, they should be avoided or used with caution in these clients.
D. Tetracyclines have a different structure from penicillins and are usually safe for clients with penicillin allergies.