A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow-up by the nurse?

A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow-up by the nurse?

• A. Takes metformin hydrochloride for type 2 diabetes mellitus.
• B. Report of client's sobriety for the last five years.
• C. CT scan that was performed six months earlier.
• D. Metal hip prosthesis was placed twenty years ago.

Answer: (A)

Holding metformin before a contrast-enhanced CT is essential. Iodinated contrast can momentarily affect kidney function, and metformin is cleared by the kidneys. If renal function declines, metformin can accumulate and increase the risk of lactic acidosis, a serious complication. Therefore, the nurse should follow up on whether metformin will be withheld around the time of the contrast study and whether kidney function will be checked before and after the procedure. The other history details—recent sobriety, a CT done six months ago, or a metal hip prosthesis—don’t impact the safety of a contrast CT in the same way and aren’t contraindications for the procedure.

Holding metformin before a contrast-enhanced CT is essential. Iodinated contrast can momentarily affect kidney function, and metformin is cleared by the kidneys. If renal function declines, metformin can accumulate and increase the risk of lactic acidosis, a serious complication. Therefore, the nurse should follow up on whether metformin will be withheld around the time of the contrast study and whether kidney function will be checked before and after the procedure. The other history details—recent sobriety, a CT done six months ago, or a metal hip prosthesis—don’t impact the safety of a contrast CT in the same way and aren’t contraindications for the procedure.