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 C
Explanation
A. Lithium is not considered addictive in the traditional sense, and it does not need to be discontinued after six months unless clinically indicated.
B. Diuretics are generally avoided in patients taking lithium due to the risk of lithium toxicity from altered renal clearance, rather than being a routine prescription for difficulty urinating.
C. Close monitoring of lithium levels is crucial to avoid toxicity and ensure therapeutic efficacy, making this statement correct and essential for the patient’s education.
D. While weight gain can occur with lithium therapy, it is not an indicator of lithium toxicity; symptoms of toxicity include nausea, tremors, and confusion rather than weight gain.
Correct Answer is B
Explanation
A. Tardive dyskinesia is primarily associated with long-term use of antipsychotics, not SSRIs like sertraline.
B. Serotonin syndrome is a serious condition that can occur with overdose or interaction of SSRIs, leading to symptoms such as agitation, confusion, rapid heart rate, and increased muscle tone.
C. Hypertensive emergency is not typically associated with SSRIs; it is more related to the use of MAOIs and certain foods.
D. Extrapyramidal syndrome is also primarily linked to antipsychotics rather than SSRIs and would not be a concern with sertraline use.