A 48-year-old patient with stage 2 chronic kidney disease (CKD) is scheduled for an intravenous pyelogram (IVP). Which order for the patient will the nurse question?
a. NPO for 6 hours before procedure
b. Ibuprofen (Advil) 400 mg PO PRN for pain
c. Dulcolax suppository 4 hours before procedure
d. Normal saline 500 mL IV infused before procedure
ANS: B
The contrast dye used in IVPs is potentially nephrotoxic, and concurrent use of other nephrotoxic medications such as the nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided. The suppository and NPO status are necessary to ensure adequate visualization during the IVP. IV fluids are used to ensure adequate hydration, which helps reduce the risk for contrast-induced renal failure.
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