RISK FOR ADVERSE REACTION TO IODINATED CONTRAST MEDIA Nursing Care Plan

Do you also have allergies? Do you know that it is really important that others know your allergies? You must not hide it or feel shame of it even it is the worst allergy. Most people experienced life-threatening situation when they expose to their allergen. As a nurse, you must ask your patient if they have allergies especially allergy in medication, substance, and food. Levine, a 47 years l old female who works in a telemarketing company, recently diagnosed with a mass in left breast. The said that she needs a CT scan to check the mass. She needs to infused iodine contest media but unfortunately, the nurse learned that she is allergic to iodine. Below is a sample of nursing care plan for risk of adverse reaction to iodine contrast media. 

ASSESSMENT:

Subjective:
"I have an allergy to iodine", the patient said verbally.

Objectives:
- Anxiety
- Records of past history of allergic to iodine

- Vital signs normal

- Visible mass on chest

DIAGNOSIS:

Risk for adverse reaction to iodinated contrast media related to history of allergy to iodine.

PLANNING:

After 1 hour of nursing intervention, the patient will be able to understand the need to report and describe the delayed reactions of iodinated contrast media.

INTERVENTIONS: 

- Check Levine's history of allergic reactions to iodine. Check if the recent allergic reaction is mild or severe.

- Discuss to the patient that there's alternative contrast dye that does not have iodine so doing CT scan is still possible. Galodinium is once of those alternatives, it does not contain iodine, however each contrast media have different disadvantages. The radiologist will provide the appropriate contrast media to the patient with allergy to iodine like Levine.

- Explain to the patient that it takes 3 hours to 7 days before there contrast media reaction occurs. Explain the delayed reaction to the patient and her family. Advise the patient and the family that report to the doctor if the patient experience widespread rashes, pruritus without hives, nausea, vomiting, drowsiness, and headache.

- Difficulty of breathing or swallowing are one of the most life-threatening allergic reactions and the patient, Levine, or the family must go immediately to the emergency room.

- Advice Levine, the patient, to drink a lot of fluids because it can help the kidneys to remove the iodinated contrast media immediately. It is recommended to drink 2 to 3 liters of water.

- Tell the patient that she may experience urge to urinate after injecting the contrast media and it is normal. Discuss to Levine, the patient that her urine must not change in color because of the iodinated contrast media and report if there's bright red color in her urine. However, it is really rare to cause problem in the kidney with contrast media.

EVALUATION:

After 1 hour of nursing intervention, the patient understood the need to report and described the delayed reactions of iodinated contrast media.

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