The client is going to radiology for a computed tomography (CT) scan without contrast. Which client data is the nurse's priority because it requires nurse-provider collaboration?

Question

1. Septicemia
2. Renal failure
3. Laryngospasm
4. Claustrophobia

Answer 1

3
3. Laryngospasm severely impairs the airway, restricting ventilation and ultimately gas exchange. The nurse cannot send the client anywhere with an impaired airway because an airway is the client's highest priority physical need. The nurse and the provider need to discuss rescheduling the scan and management of the client's air-way. Clients can undergo CT scans while intubated with the nurse and respiratory therapist in attendance; however, only a stable intubated client is eligible and at this point the client is not stable. In addition, intubating the client does not exclude the possibility of continuing airway problems.
1 and 2. Septicemia and renal failure are not contraindications to CT scan because the test does not use contrast dye.
4. The nurse needs to discuss the client's claustrophobia with the provider and plan suitable nursing care and medical therapy. If another diagnostic test cannot provide equivalent information to the CT scan, the client potentially needs short-term sedation because the test requires the client to slide into a long hollow cylinder completely encasing the client's body with radiation for approximately 15 to 30 minutes. Clients who are claustrophobic potentially feel distress and risk interrupting the test at a tremendous cost.