A patient is scheduled for a CT scan of the abdomen with contrast. The patient has a baseline creatinine of 2.3 mg/dL. In preparing this patient for the procedure, the nurse anticipates what orders?
A) Monitor the patient's electrolyte values every hour before the procedure
B) Preprocedure hydration and administration of acetylcysteine
C) Hemodialysis immediately prior to the CT scan
D) Obtain a creatinine clearance by collecting a 24-hour urine specimen
Ans: B
Feedback: Radiocontrast-induced nephropathy is a major cause of hospital-acquired acute renal failure. Baseline levels of creatinine greater than 2 mg/dL identify the patient as being high risk. Preprocedure hydration and prescription of acetylcysteine (Mucomyst) the day prior to the test is effective in prevention. The nurse would not monitor the patient's electrolytes every hour preprocedure. Nothing in the scenario indicates the need for hemodialysis. A creatinine clearance is not necessary prior to a CT scan with contrast.
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