A patient was admitted this morning for an elective percutaneous coronary intervention. The nurse would alert the health care provider if the patient makes which statement?
1. "My blood sugar was high yesterday, so I took my metformin as prescribed last night.".
2. "I have not had anything to eat or drink since midnight last night.".
3. "I am eager to get this procedure over with so I can go to my grandson's baseball game next week.".
4. "I did not sleep well last night.".
1
Rationale 1: Metformin has been associated with an increased risk of lactic acidosis after contrast administration. The drug is generally held for several days prior to contrast administration. A different form of blood glucose control is prescribed if indicated.
Rationale 2: This is a standard NPO regimen and does not require special notification of the health care provider.
Rationale 3: If all goes well during the procedure, there should be no contraindication to the patient's plan.
Rationale 4: The patient may be anxious about the procedure, which would interfere with sleep. The nurse should ask additional questions to determine if notification of the health care provider is indicated.
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