During an arteriogram (angiogram), the patient suddenly says, "I'm feeling really hot". Which is the best res… - GMCH Chandigarh - 2019

GMCH Chandigarh - 2019

Medical & Surgical Nursing

Medium

Appeared in: GMCH Chandigarh - 2019

Explanation

The injection of radiopaque contrast dye during an angiogram commonly causes a transient sensation of warmth or flushing.
This is a normal, expected physiological response and is not indicative of a complication.
The nurse's best response is to provide accurate information and reassurance, which alleviates patient anxiety.
The sensation is brief, typically lasting for less than a minute, as stated in the correct option.

Option A: A feeling of warmth alone is not sufficient to diagnose an allergic reaction. True allergic reactions typically present with additional signs like hives (urticaria), itching, wheezing, or hypotension.
Option B: An angiogram is a diagnostic imaging procedure used to visualize blood vessels. It does not have a therapeutic effect of dissolving clots (thrombolysis).
Option C: The patient's sensation is an internal feeling of heat caused by the vasodilatory effect of the contrast dye, not the external ambient temperature of the room.

Clinical Relevance

Nursing practice connection: Use the key finding related to Patient care during angiography and management of contrast dye side effects to guide bedside assessment, documentation, and the next nursing action.
A key nursing role during procedures involving contrast dye is patient education. Informing the patient about expected sensations like warmth beforehand can significantly reduce anxiety and prevent misinterpretation of normal side effects.
Nurses must be able to rapidly differentiate between common, expected side effects and signs of a true adverse reaction to initiate appropriate and timely interventions, ensuring patient safety.
What if? If the patient had said, 'I'm feeling really hot and my throat feels tight,' the priority would shift immediately. This suggests an anaphylactoid reaction. The nurse's best response would be to stop the infusion, call for immediate medical assistance, and prepare to administer emergency medications like epinephrine.

How to Approach the Question

First, identify the clinical context: a patient is undergoing an angiogram, a procedure that involves contrast dye injection.
Next, analyze the patient's statement: 'I'm feeling really hot.' This is a subjective symptom that occurs during the procedure.
Recall or look up the known side effects of intravenous contrast dye. A sensation of warmth or flushing is a very common and expected side effect.
Evaluate each response option based on whether it is factually correct, therapeutic, and provides appropriate reassurance.
Eliminate options that are factually incorrect (angiograms don't dissolve clots), represent a premature or incorrect diagnosis (assuming an allergy without sufficient signs), or are irrelevant to the cause (checking room temperature for an internal sensation).
Select the option that correctly identifies the sensation as a normal, transient side effect and reassures the patient, as this is the best therapeutic communication in this scenario.

Concept Tested & Keywords

Concept Tested: Patient care during angiography and management of contrast dye side effects.
Stem keywords: arteriogram, angiogram, feeling really hot
Lead-in keywords: best response
Clinical cues: Patient statement: 'I'm feeling really hot' - indicates a subjective sensation requiring nursing assessment and intervention.
Negative lead-in flag: false