Medical Surgical Kidney stones #5

Question

The nurse prepares a client for an intravenous pyelogram (IVP) and should include which action as part of the pre-planning for the IVP? Choose the best answer.

Answers

  1. Checking the client's history for iodine.
    • Rationale:

      This answer is correct because the contrast used for IVP contains iodine. By verifying the client’s allergies before the procedure, the nurse is ensuring client safety. There is a misconception that an allergy to shellfish is conducive to an allergy to iodine. This is false information. Those allergic to shellfish are allergic to specific proteins in these foods, not the iodine content. Iodine is not the trigger for those allergic to shellfish, therefore, IVP is not contraindicated in a client with a shellfish allergy .

  2. Checking the record for the previous day’s intake and output.
    • Rationale:

      This answer is not correct because it is not the best answer. While checking history of intake and output is important, it is not as critical as determining if the client has an allergy to iodine.

  3. Checking the record for time and date of last bowel movement.
    • Rationale:

      This answer is not correct because the client will have had a laxative the day before to clear out the bowels before the IVP. Though, checking history of intake and output, including bowel movements, is important.

  4. Instructing the client on straining urine following the procedure.
    • Rationale:

      This answer is not correct because the IVP procedure does not promote the release of the stone(s). This is only a diagnostic tool used to determine location of the calculi; therefore, the nurse does not educate straining the urine in the pre-procedure instruction.

Overview

An intravenous pyelogram (IVP) is a type of x-ray that provides images of the urinary tract by injecting an iodine-containing contrast through a vein in the arm. This procedure is contraindicated for clients who have an allergy to iodine.

Explanation

Learning Outcomes

During an IVP, a health care provider will inject iodine-containing contrast dye into an intravenous access device. The dye travels through the bloodstream and into the urinary tract allowing visualization on x-ray. Therefore, the most important pre-planning for an IVP is to verify if the client has an allergy to iodine. There is a misconception that an allergy to shellfish is conducive to an allergy to iodine. This is false information. Those allergic to shellfish are allergic to specific proteins in these foods, not the iodine content. Iodine is not the trigger for those allergic to shellfish, therefore, IVP is not contraindicated in a client with a shellfish allergy .

Test Taking Tip

Consider the substance that is administered to the client for an IVP to answer this question correctly.

Video Rationale