00218 Risk Of Adverse Reaction To Iodized Contrast Media

Domain 11: security/protection
Class 5: defensive processes
Diagnostic Code: 00218
Nanda label: adverse reaction risk to iodized contrast media
Diagnostic focus: adverse reaction to iodized contrast media
Approved 2010 • Revised 2013, 2017 • Evidence level 2.1

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « risk of adverse reaction to iodized contrast media contrast injection and that can compromise health.

Risk factors

  • Dehydration
  • generalized weakness

Risk population

  • People with extreme ages
  • People with a history of adverse effects to the yodado contrast environment
  • People with a history of allergy

Associated problems

  • Chronic disease
  • Concurrent use of pharmacological agents
  • Decrease in the level of consciousness
  • People with fragile veins

Suggestions of use

  • Because independent nursing actions for this diagnosis are mainly to monitor risk factors, it should be better as a collaboration problem. Many of the risk factors will only respond to a collaboration treatment.
  • This diagnosis focuses very specifically on a single allergen, and should be used instead of allergic response risk if the reaction of risk factors to the iodinated contrast media occurs.

Suggested alternative diagnostics

  • injury, risk of
  • Allergic response, risk of

NOC Results

  • Noc results have not yet been formally associated with this diagnosis, although the following could be useful:
  • Allergic response: Located: Severity of the hypersensitive immune response located before an environmental (exogenous) antigen determined
  • Allergic response: systemic: severity of the systemic hypersensitive immune reaction to a specific environmental antigen (exogenous)

Evaluation objectives and criteria

  • • Does not experience an allergic response, as evidenced by not presenting an allergic response: localized or systemic.
  • • Prove that it has no allergic response: systemic, as the following indicators express (specify from 1 to 5: severe, substantial, moderate, light or none):
    • Anaphylactic shock
    • Decrease in blood pressure
    • Facial edema
    • Edema laryngeal
    • nausea, vomiting
    • Sibilations, rales, or dyspnea at rest
    • tachycardia or arrhythmias
    • Urticaria
  • Other examples

    • • It does not present rum (signal of edema laryngeal)
    • • No convulsive activity
    • • Does not present localized or systemic allergic responses (for example, cutaneous, respiratory, cardiac, gastrointestinal, musculoskeletal)

    NIC Interventions

    • NIC interventions have not yet been formally associated with this diagnosis, although the following could be useful:
    • Medication administration: preparation, administration and evaluation of the effectiveness of prescribed and non -prescribed drugs
    • Risk identification: Analysis of possible risk factors, determination of health risks and prioritization of risk reduction strategies for a person or group
    • Tissue integrity: mucous skin and membranes: intact structure and normal physiological function of the skin and mucous membranes
    • Allergy Management: Identification, treatment and prevention of allergic responses to food, medicines, insect bites, contrast material, blood or other substances
    • Management of the environment: manipulation of the patient’s environment to achieve therapeutic benefit, sensory reference and psychological well -being
    • Respiratory monitoring: Patient data collection and analysis to ensure the permeability of the respiratory tract and an adequate gas exchange
    • Surveillance: Collection, interpretation and synthesis of patient data, continuous and with an end, to make clinical decisions

    Nursing Activities

    Nursing activities for this diagnosis focus on evaluating risk factors for an adverse reaction to iodized contrast media and notifying this observation to the treating physician.

    Valuations

    • • Determine if there is a history of reactions to the iodized contrast agents
    • • Verify if there is an asthma history or multiple serious allergies
      • Assess risk factors as an underlying disease (for example, renal failure)
      • Verify the results of the laboratory for serum creatinine and
      • Estimated glomerular filtration index
      • Obtain a list of current and recent medicines of the patient (for example, metformin)
      • Monitor the symptoms of a reaction to the contrast medium (for example, hypotension, whistles, facial edema, rum/edema laryngeal, changes in mental state)
      • Observe the extravasation of the contrast medium

    Collaboration activities

    • • Apply and monitor pulse oximetry
    • • Make sure there is oxygen available. Manage it if necessary
    • • Make sure the right equipment in the room where a reaction could occur (for example, mask respirator, red car, IV solutions, pulse oximetry)
    • • Be familiar with the medications included in the boxes for reactions to contrast media and be prepared to help administer them, as required (for example, epinephrine, atropine, corticosteroids)

    Others

    • • Monitor the pulse and blood pressure according to the protocol
    • • Auscultate the lungs according to the protocol
    • • Monitor pulse oximetry
    • • Monitor the presence of facial edema and skin coloration
    • • Notify the doctor immediately if any reaction symptom is presented
    • • If a reaction occurs, keep calm and stand firm