Question

A client is scheduled for a bone scan to determine the presence of metastasis. Which information is most important that the nurse obtain prior to the proce- dure? ? A. Allergies for shellfish and iodine ? B. Blood, urea, and nitrogen (BUN ) and creatinine (Cr) ? C. A signed consent form ? D. Venipuncture for intravenous access

Short answer

Answer: Blood, urea, and nitrogen (BUN) and creatinine (Cr) values.

Step-by-step solution

Option A: Allergies for shellfish and iodine

Although it is important to know if a patient has allergies to shellfish and iodine, this information may not be directly related to a bone scan procedure. Most radioactive tracers used in bone scans do not contain shellfish or iodine substances.

Option B: Blood, urea, and nitrogen (BUN) and creatinine (Cr)

These laboratory values provide information about the patient's kidney function. Since bone scans require the administration of a radioactive tracer, which is excreted by the kidneys, it is essential to determine if the patient's kidneys are functioning properly before the procedure. This option is a strong candidate for the correct answer.

Option C: A signed consent form

Obtaining a signed consent form is important before any medical procedure, as it indicates that the patient understands and agrees to the risks and benefits of the procedure. However, this does not provide any specific information necessary for a bone scan.

Option D: Venipuncture for intravenous access

Venipuncture is required for the administration of the radioactive tracer in the bone scan procedure. It is essential, but it does not provide information about the patient's health or safety during the procedure. From the analysis of the options given, it is clear that the most important information for the nurse to obtain prior to the bone scan is:

Correct Answer: Option B

Blood, urea, and nitrogen (BUN) and creatinine (Cr) values are crucial for determining if a patient's kidneys are functioning well enough to undergo the bone scan. It is the most important information to be obtained because it directly affects the patient's health and safety during the procedure.

Key concepts

Patient Safety in Medical Procedures

Ensuring patient safety is paramount in all medical procedures, including radiological imaging like bone scans. This encompasses a thorough review of potential risks, allergies, and the use of contrast agents that may affect the patient. The use of a radioactive tracer in bone scans makes assessing the patient's ability to process and excrete the substance essential. Therefore, prior to the procedure, nurses must confirm that the correct patient identification protocols are followed, review any potential allergies, and verify that the patient understands the risks involved.

Providers should also be vigilant about potential interactions with existing medications or health conditions. A well-prepared medical team is critical to manage any unforeseen immediate allergic reactions or adverse effects, with resuscitation equipment and medications readily available.

Kidney Function Assessment

Assessing kidney function is one of the cornerstones of pre-procedural patient preparation, especially when the kidneys are responsible for excreting contrast agents used in procedures like bone scans. Blood tests measuring the blood urea nitrogen (BUN) and creatinine levels are essential indicators of renal performance.

The results can reveal if the kidneys are filtering waste efficiently. Elevated levels may indicate reduced kidney function, which can affect the patient's ability to clear the radioactive tracer used in a bone scan. Nurses should ensure current laboratory values are reviewed before administering any contrast media to mitigate risks of nephrotoxicity and other complications.

Radiological Imaging and Contrast Media

Understanding radiological imaging and contrast media is fundamental for nursing staff involved in diagnostic tests, such as bone scans. While bone scans typically use technetium-based tracers, rather than iodine-based contrasts used in other radiological exams, proper preparation is still vital.

Nurses should have knowledge of the types of contrast agents used and their potential side effects. Importantly, they must recognize that patient education is a key factor for informed consent and for mitigating anxiety regarding the procedure. Clear instructions about what the procedure entails and any necessary post-procedural follow-up care are crucial components of patient-centered care.

Pre-procedural Patient Assessment

Pre-procedural patient assessment is an integral part of the nursing process to ensure a safe medical procedure. This multidimensional evaluation includes obtaining a comprehensive health history, current medications, allergies, and specific assessments needed for particular procedures, such as renal function tests before a bone scan.

In addition to the physical assessment, it's important to gauge the patient's psychological readiness and provide emotional support. Establishing a baseline before the procedure allows for continuous monitoring for any changes or complications. This proactive approach is instrumental in mitigating risks and ensuring a safe, effective procedure.