Question

A patient with diabetic nephropathy is undergoing a radiologic procedure with radiocontrast dye under general anesthesia. What actions by the anesthesia provider will limit the renal effects of the dye?

1) Administration of ketorolac (toradol)
2) Prehydrate with IV fluids
3) Pretreatment with N-acetylcysteine
4) Use of hypotensive technique

Answer 1

To limit the renal effects of radiocontrast dye in a patient with diabetic nephropathy undergoing a radiologic procedure under general anesthesia, the anesthesia provider can prehydrate with IV fluids, pretreat with N-acetylcysteine, and use a hypotensive technique.

Step-by-step explanation:

In order to limit the renal effects of radiocontrast dye in a patient with diabetic nephropathy undergoing a radiologic procedure under general anesthesia, there are several actions that the anesthesia provider can take:

1. Prehydrate with IV fluids: Adequate hydration helps to protect the kidneys and maintain renal function.
2. Pretreatment with N-acetylcysteine: N-acetylcysteine is an antioxidant that can help reduce the risk of contrast-induced nephropathy.
3. Use of hypotensive technique: By using a hypotensive technique during the procedure, the anesthesia provider can help minimize the renal effects of the dye.

Answer 2

When a patient with diabetic nephropathy undergoes a radiologic procedure with radiocontrast dye under general anesthesia, there are several actions that the anesthesia provider can take to limit the renal effects of the dye. These include prehydration with IV fluids, pretreatment with N-acetylcysteine, and avoiding the use of ketorolac and hypotensive techniques.

Step-by-step explanation:

When a patient with diabetic nephropathy undergoes a radiologic procedure with radiocontrast dye under general anesthesia, there are certain actions that the anesthesia provider can take to limit the renal effects of the dye.

1. Administration of ketorolac (toradol) is not recommended as it is a nonsteroidal anti-inflammatory drug (NSAID) which can potentially worsen kidney function in patients with diabetic nephropathy.
2. Prehydrating the patient with IV fluids is an important preventive measure to protect the kidneys. By increasing the patient's fluid volume, it helps to flush out or dilute the contrast dye, reducing its concentration and potential damage to the kidneys.
3. Pretreatment with N-acetylcysteine has been shown to have some protective effects on the kidneys. It acts as an antioxidant and can help reduce the oxidative stress caused by the contrast dye.
4. Using a hypotensive technique is not recommended as it can further compromise kidney function by reducing renal blood flow.