Question

A client with diabetes mellitus type 2 has been well controlled with metformin. The client is scheduled for magnetic resonance imaging (MRI) scan with contrast. What priority would the nurse take at this time?

a. Teach the client about the purpose of the MRI.
b. Assess the client's blood urea nitrogen and creatinine.
c. Tell the client to withhold metformin for 24 hours before the MRI.
d. Ask the client if he or she is taking antibiotics.

Answer 1

The nurse should prioritize assessing the client's blood urea nitrogen and creatinine levels before an MRI scan with contrast to prevent nephrotoxicity and to inform patient management, such as withholding metformin if necessary.

Step-by-step explanation:

The priority action a nurse should take when a client with diabetes mellitus type 2 who is well controlled with metformin is scheduled for an MRI scan with contrast is to assess the client's blood urea nitrogen (BUN) and creatinine. This is because the contrast agent used, often containing gadolinium, can potentially cause nephrotoxicity, particularly in individuals with pre-existing kidney issues. Metformin can also lead to lactic acidosis in cases of impaired kidney function. Therefore, checking BUN and creatinine levels can help determine the patient's kidney function before the use of contrast agents. While it is also important to withhold metformin in these cases, assessing kidney function is a priority because it informs the decision on whether to withhold metformin and helps prevent potential contrast-induced nephropathy.