A client is scheduled for percutaneous coronary intervention in the morning. Which of the following would warrant a call to the health care provider by the nurse?
1. Client has an order for metformin each morning.
2. Client's serum creatinine is 1.0 mg/dL.
3. Client takes warfarin at home and current INR is 1.
4. Client's potassium level is 3.8 mEq/L.
Client has an order for metformin each morning.
Rationale: Metformin has been associated with an increased risk for lactic acidosis after PCI. The drug should be held on the day of the procedure and for 48 hours after the procedure. The nurse will need to contact the health care provider for such orders. The client's creatinine, INR, and potassium level are all within normal limits, so no intervention is necessary.
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