Page 1676 - Saunders Comprehensive Review For NCLEX-RN

If a client taking metformin is scheduled to

undergo a procedure requiring the administration of
iodine dye, the metformin is withheld for 24 hours
prior to the procedure because of the risk of lactic
acidosis. The medication is not resumed until
prescribed by the PHCP (usually 48 hours after the
procedure or after renal function studies are done
and the results are evaluated).

3. Postprocedure interventions

a. Monitor vital signs and cardiac rhythm
for dysrhythmias at least every 30
minutes for 2 hours initially.
b. Assess for chest pain and, if
dysrhythmias or chest pain occurs,
notify the PHCP.
c. Monitor peripheral pulses and the color,
warmth, and sensation of the extremity
distal to the insertion site at least every
30 minutes for 2 hours initially.
d. Notify the PHCP if the client reports
numbness and tingling; if the
extremity becomes cool, pale, or
cyanotic; or if loss of the peripheral
pulses occurs. This could indicate clot
formation and is an emergency.
e. Apply a sandbag or compression device
(if prescribed) to the insertion site to
provide additional pressure if
required.
f. Monitor for bleeding; if bleeding occurs,
apply manual pressure immediately
and notify the PHCP.
g. Monitor for hematoma; if a hematoma
develops, notify the PHCP.
h. Keep the extremity extended for 4 to 6
hours, as prescribed, keeping the leg
straight to prevent arterial occlusion.
i. Maintain strict bed rest for 6 to 12 hours,
as prescribed; however, the client may
turn from side to side. Do not elevate
the head of the bed more than 15
degrees.
j. If the antecubital vessel was used,
immobilize the arm with an armboard.
k. If the PHCP uses a vascular closure
device to seal the arterial puncture site,
there is no need for prolonged

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