Editing Reduction of Risk Potential – RN Practice Questions (section)

==Question 10==
A client with type 2 diabetes who takes metformin is scheduled for a computed tomography scan with iodinated contrast. The serum creatinine is 1.9 mg/dL. Which nursing action is most important?
# Verify the plan for withholding metformin around the time of contrast administration and confirm hydration orders.
# Hold the client's morning insulin and check a fingerstick glucose.
# Ask the client whether shellfish causes a rash, and cancel the study if so.
# Administer the metformin with a small sip of water to maintain glycemic control.

'''Answer:''' Option 1. Verify the plan for withholding metformin around the time of contrast administration and confirm hydration orders.

''Rationale:'' Impaired renal function raises the risk of contrast-associated kidney injury, and reduced metformin clearance in that setting raises the risk of lactic acidosis. Standard practice is to withhold metformin at the time of contrast and for approximately 48 hours afterward in at-risk clients, restarting only after renal function is reassessed, along with adequate hydration. Option 3 reflects an outdated belief; shellfish allergy does not predict contrast reaction, whereas a prior reaction to contrast itself does. Option 4 is unsafe, and option 2 does not address the primary risk.