Nclexrn Flashcards: Diagnostic Tests And Contrast Allergy Precautions

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This deck focuses on Diagnostic Tests And Contrast Allergy Precautions, giving you a quick way to review the definitions, rules, and examples that matter most for Nclexrn.

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Work through these flashcards in short sessions. Try to answer each prompt before flipping the card, then revisit any cards you miss until the explanation feels automatic.

Flashcard 1: What instruction should be given after iodinated contrast if no fluid restriction exists?

Answer: Increase oral fluids to help excrete contrast. Enhanced hydration promotes renal clearance, reducing retention and potential toxicity.

Flashcard 2: Which medication should be held around iodinated contrast administration due to lactic acidosis risk if AKI occurs?

Answer: Metformin. Contrast-induced AKI can cause metformin accumulation, increasing lactic acidosis risk in diabetic patients.

Flashcard 3: What is the immediate nursing action for suspected contrast extravasation at an IV site?

Answer: Stop injection, elevate limb, and notify radiology/provider. Immediate cessation and elevation reduce tissue exposure to hyperosmolar contrast, minimizing necrosis risk.

Flashcard 4: Which complication is a priority to monitor for after a barium enema, especially in older adults?

Answer: Constipation or fecal impaction. Retained barium can harden, leading to obstruction, particularly in those with reduced motility.

Flashcard 5: Identify the best nursing response when a patient says, "I cannot have contrast because I am allergic to shellfish."

Answer: Shellfish allergy alone does not predict contrast reaction; assess prior contrast reaction. This educates on the iodine myth and refocuses on true predictors like prior contrast exposure.

Flashcard 6: Which action should the nurse take first when a patient with prior contrast anaphylaxis arrives for a contrast CT without premedication orders?

Answer: Hold the study and notify provider/radiology for an alternative or premedication plan. History of anaphylaxis necessitates premedication or non-contrast options to avoid life-threatening recurrence.

Flashcard 7: What is the priority assessment immediately after IV contrast administration during CT?

Answer: Airway and breathing for early hypersensitivity reaction. Contrast can trigger rapid anaphylactoid reactions, necessitating vigilant monitoring for airway compromise.

Flashcard 8: Which patient condition increases risk for contrast-associated kidney injury and requires extra precautions?

Answer: Chronic kidney disease (reduced eGFR). Reduced clearance prolongs contrast exposure, heightening nephrotoxic effects on tubules and vasculature.

Flashcard 9: Which symptom indicates a severe contrast reaction requiring emergency response?

Answer: Stridor with respiratory distress. Stridor signals laryngeal edema or bronchospasm, escalating to potential airway obstruction in anaphylaxis.

Flashcard 10: Which pre-procedure action is essential before any contrast study to prevent wrong-patient or wrong-allergy errors?

Answer: Verify patient identity and documented allergies. Accurate verification upholds safety protocols, preventing administration errors and allergic complications.

Flashcard 11: Which imaging study commonly uses barium sulfate as oral or rectal contrast?

Answer: Upper GI series or barium enema (lower GI series). Barium's high atomic number provides radiopacity for detailed GI tract visualization under fluoroscopy.

Flashcard 12: Which patient is at highest risk for nephrogenic systemic fibrosis with gadolinium contrast?

Answer: Patient with severe renal failure (very low eGFR). Impaired excretion in renal failure allows gadolinium deposition, triggering fibrotic skin and organ changes.

Flashcard 13: What is the key nursing action when a patient reports a prior contrast reaction before a CT with contrast?

Answer: Notify provider and radiology; do not administer until evaluated. This allows for risk assessment, potential premedication with steroids/antihistamines, or alternative imaging to ensure safety.

Flashcard 14: What is the key post-procedure nursing instruction after a barium study?

Answer: Increase fluids and fiber; expect light/white stools. This promotes barium excretion to prevent constipation and informs about temporary stool discoloration from residual contrast.

Flashcard 15: Which patient history finding is the strongest predictor of iodinated contrast reaction risk?

Answer: Prior allergic-like reaction to iodinated contrast. A prior reaction indicates sensitization, making recurrence up to 60% more likely without premedication.

Flashcard 16: What is the priority screening question before MRI to prevent device-related injury?

Answer: Presence of implanted ferromagnetic metal or pacemaker/ICD. Strong magnetic fields can torque metals or interfere with device function, risking burns or malfunctions.

Flashcard 17: Which symptom is most consistent with a mild iodinated contrast reaction?

Answer: Limited urticaria or pruritus. Mild reactions often involve histamine-mediated skin symptoms without systemic involvement.

Flashcard 18: Which order should the nurse question for a CT with iodinated contrast in a patient with eGFR $20$ mL/min/1.73 m$^2$?

Answer: Proceeding with iodinated contrast without renal-risk mitigation plan. Severely reduced eGFR heightens AKI risk, requiring hydration, low-osmolar contrast, or alternatives.

Flashcard 19: Which contrast agent is typically used for MRI enhancement instead of iodinated contrast?

Answer: Gadolinium-based contrast. Gadolinium shortens T1 relaxation times, enhancing signal intensity in vascular and pathological tissues on MRI.

Flashcard 20: Identify the correct action when a patient reports wheezing and facial swelling during contrast injection.

Answer: Stop contrast, call rapid response, maintain airway, give O2. These signs indicate anaphylaxis, demanding prompt intervention to prevent respiratory failure.

Flashcard 21: Which allergy history does NOT reliably predict iodinated contrast allergy and should not be treated as equivalent?

Answer: Shellfish allergy. Shellfish reactions stem from proteins like tropomyosin, not iodine, lacking correlation with contrast hypersensitivity.

Flashcard 22: Which baseline lab is most important to review before iodinated contrast in a patient with kidney disease?

Answer: Serum creatinine or estimated glomerular filtration rate (eGFR). These metrics evaluate renal function to stratify risk for contrast-induced nephropathy before administration.

Flashcard 23: What is the priority nursing intervention to reduce kidney injury risk with iodinated contrast when ordered?

Answer: Ensure adequate hydration as prescribed. Pre- and post-procedure hydration dilutes contrast and enhances renal perfusion, mitigating nephrotoxicity.

Flashcard 24: Which instruction is most appropriate for a patient who had a barium swallow this morning and has not had a bowel movement?

Answer: Increase fluids and fiber; use laxative if prescribed. These measures facilitate barium passage through the GI tract, averting impaction from delayed elimination.

Flashcard 25: What is the main renal risk associated with iodinated IV contrast in CT imaging?

Answer: Contrast-associated acute kidney injury. Iodinated agents can induce tubular toxicity and vasoconstriction, impairing renal function in at-risk patients.