What is the most important action for a nurse preparing a client for intravenous pyelography (IVP)?

The most important action when preparing a client for intravenous pyelography (IVP) is to question the client about allergies to iodine or shellfish. This procedure involves the administration of a contrast dye that usually contains iodine, which can provoke allergic reactions in individuals who are sensitive to it. Identifying any history of allergies—especially to iodine or shellfish (which can indicate a potential allergy to the contrast medium)—is crucial for the nurse to ensure the client's safety and to prevent adverse reactions during the procedure.

Addressing allergies is a priority because an allergic reaction can lead to serious complications, including anaphylaxis. Even if the client does not exhibit allergies to shellfish, previous reactions to iodine-based contrast agents should be assessed fully. This proactive measure allows for potential pre-treatment with antihistamines or corticosteroids if an allergy is identified, thus enabling a safer environment for the client during the IVP.

While confirming understanding of the procedure, assessing vital signs, or obtaining informed consent are also important nursing actions, safeguarding the client’s health by ensuring there are no allergies to the contrast medium takes precedence in this context.