Pharmacology Urinary & Renal Meds #2

Question

The nurse is preparing a patient who has a kidney stone for an intravenous pyelogram (IVP) and should include which action as part of the pre-planning for the IVP?

Answers

  1. Checking if the patient is allergic to iodine.
    • Rationale:

      This answer is correct because before an IVP, the patient must be asked about allergies, particularly to shellfish or iodine. The radiopaque iodine-based dye is contraindicated if the patient is allergic to iodine or shellfish. If allergy to iodine or shellfish is present, the patient is at risk for a serious reaction to the IVP contrast material.

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

      This answer is not correct because while checking history of intake and output (both urine, bowel movements, and fluids) is important, it is not as critical as determining allergy to iodine or shellfish. If allergy to iodine or shellfish is present, the patient is at risk for a serious reaction to the IVP contrast material.

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

      This answer is not correct because while checking history bowel movement is important, it is not as critical as determining allergy to iodine or shellfish. If allergy to iodine or shellfish is present, the patient is at risk for a serious reaction to the IVP contrast material.

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

      This answer is not correct because the procedure itself does not necessarily promote release of the stone(s) as it is only a diagnostic imaging to determine location of the calculi. Straining the urine is a nursing intervention for renal calculi anyway, and the question centers on prep for the IVP.

Overview

Intravenous pyelogram (IVP) is a diagnostic test that uses IV administration of contrast dye. The most important pre-planning for an IVP is checking allergies, particularly to iodine and/or shellfish.

Explanation

The most important pre-planning for an IVP is rechecking allergies, particularly to iodine and/or shellfish. If allergy is present, the client is at risk for serious reaction to the IVP contrast material. While checking history of intake and output (both urine, bowel movements, and fluids) is important it is not as critical as determining allergy to iodine. The procedure itself may not promote release of the stone(s) as it is only a diagnostic imaging to determine location of the calculi. Straining the urine is a nursing intervention for renal calculi anyway, and the question centers on prep for the IVP.

Learning Outcomes

Intravenous pyelogram (IVP) is a diagnostic x-ray that involves using IV administration of contrast dye to highlight and assess the kidneys, ureters, and bladder. The IVP is different from the basic kidneys, ureters, and bladder (KUB) x-ray in that with the IVP, the urinary system is emphasized in this diagnostic test as it “glows” bright white on the x-ray film from the dye administered. An IVP will provide significant information about the function and structure of the urinary system. Before the test, the patient must be asked about allergies, particularly to shellfish or iodine, since the radiopaque iodine-based dye is contraindicated if the patient is allergic to iodine or shellfish.

Test Taking Tip

Safety is an important emphasis of NCLEX, including checking patient allergies and medication interactions.

Video Rationale