A female client with suspected renal dysfunction is scheduled for excretory urography. Nurse January reviews the history for conditions that may warrant changes in client preparation. Normally, a client should be mildly hypovolemic (fluid depleted) before excretory urography. Which history finding would call for the client to be well hydrated instead?
A. Cystic fibrosis
B. Multiple myeloma
C. Gout
D. Myasthenia gravis
Correct Answer: B. Multiple myeloma
Fluid depletion before excretory urography is contraindicated in clients with multiple myeloma, severe diabetes mellitus, and uric acid nephropathy — conditions that can seriously compromise renal function in fluid-depleted clients with reduced renal perfusion. If these clients must undergo excretory urography, they should be well hydrated before the test.
Option A: Cystic fibrosis is not a contraindication for excretory urography. Intravenous pyelography (IVP), or intravenous urography, is a diagnostic test that involves the administration of intravenous contrast and X-ray imaging of the urinary tract. The iodinated contrast flows through the renal vasculature and filtered into the collecting system highlighting the anatomic structures on the X-ray image.
Option C: Gout in a client undergoing excretory urography is not a contraindication. It is often useful for the evaluation of hematuria, and renal stone disease, and as a follow-up after the intervention. The urographic imaging sequence is designed to depict specific parts of the urinary tract optimally. Portions of the urinary system appear opaque when filled with contrast material.
Option D: Myasthenia gravis don’t necessitate changes in client preparation for excretory urography. The patient must empty the bladder before the procedure. Images should systematically be obtained to improve the visualization of stones and increase the soft-tissue contrast. Imaging shall include the area from the suprarenal region to below the pubic symphysis.
No comments:
Post a Comment