A client scheduled to have intravenous urography has diabetes and is taking the antidiabetic agent metformin (Glucophage). What does the nurse tell this client?
a. "Call your diabetes doctor and tell him or her that you are having an intravenous urogram performed using dye."
b. "Do not take your metformin the morning of the test because you are not going to be eating anything and you could become hypoglycemic."
c. "You must start on an antibiotic before this test because your risk of infection is greater as a result of your diabetes."
d. "You must take your metformin imme-diately before the test is performed be-cause the IV fluid and the dye contain significant amounts of sugar."
A
Metformin can cause lactic acidosis and renal impairment as the result of an interaction with the dye. This drug must be discontinued for 48 hours before the procedure and not started again after the procedure until urine output is well established. The client's endocrinologist (or health care provider managing the diabetes) needs to provide alternative therapy for the client until the metformin can be resumed.
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