Question

A patient is scheduled for a CT scan of the abdomen with contrast. The patient has a baseline creatinine level of 2.3 mg/dL. In preparing this patient for the procedure, the nurse anticipates what orders?

A) Monitor the patients 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.

Answer 1

The nurse should prepare for preprocedure hydration and administration of acetylcysteine for a patient with a creatinine level of 2.3 mg/dL scheduled for a CT scan with contrast, to protect against contrast-induced nephropathy.

Step-by-step explanation:

A patient with a baseline creatinine level of 2.3 mg/dL who is scheduled for a CT scan of the abdomen with contrast should receive particular attention due to the risk of contrast-induced nephropathy. Given the creatinine level is higher than the normal range (0.8-1.2 mg/dl for males and 0.6-0.9 mg/dl for females), the patient's renal function is already compromised.

The nurse should anticipate orders for preprocedure hydration and the administration of acetylcysteine. Hydration before the procedure helps to dilute the contrast medium, reducing its potential nephrotoxicity, and acetylcysteine can help to mitigate the risk of further renal damage. While monitoring the patient's electrolyte values is important, it is not typically done every hour before the procedure. Hemodialysis is not a standard pre-procedure for contrast CT unless the patient is already on dialysis or has severe renal impairment. A creatinine clearance test by collecting a 24-hour urine specimen may be ordered, but this would not typically be a direct preparation for the immediate CT scan procedure unless there were other specific concerns.