A nurse is preparing to administer daily medications to a client who is undergoing a procedure at 1000 that requires IV contrast dye. Which of the following routine medications to give at 0800 should the nurse withhold?

Certain medications require temporary discontinuation before procedures involving intravenous (IV) contrast dye to prevent adverse effects and complications. Iodinated contrast can affect renal function and, in combination with specific drugs, increase the risk of serious metabolic disturbances. Nurses must be aware of medication–procedure interactions to ensure patient safety. Pre-procedure medication management is an important part of reducing risks such as lactic acidosis and contrast-induced nephropathy. A. Metformin should be withheld before and after procedures involving IV contrast dye because it increases the risk of lactic acidosis if contrast-induced renal impairment occurs. Impaired kidney function can reduce metformin clearance, leading to drug accumulation and a potentially life-threatening metabolic complication. It is typically held at the time of the procedure and restarted only after renal function is confirmed to be normal. B. Fluticasone is an inhaled corticosteroid used for long-term management of asthma and allergic conditions. It does not have significant interactions with IV contrast dye and does not increase the risk of renal or metabolic complications. Therefore, it is safe to continue this medication. C. Metoprolol is a beta-blocker used for hypertension, angina, and cardiac conditions. It does not interact with contrast dye or increase the risk of contrast-related complications. Abrupt withdrawal may actually worsen cardiovascular status, so it should generally be continued unless otherwise ordered. D. Valproic acid is an anticonvulsant used to manage seizures and mood disorders. It does not have a known interaction with IV contrast dye and does not contribute to renal toxicity or lactic acidosis. Therefore, it is not necessary to withhold this medication prior to the procedure.