Choice D is correct. Iodinated contrast materials are used during cerebral angiography, potentially causing severe allergic reactions. Here, the client's itchy throat and watery eyes are classic indications of an allergic reaction that may progress to an anaphylactic reaction. Symptoms of a severe anaphylactic reaction include airway compromise due to laryngeal edema or angioedema (stridor), bronchoconstriction (wheezing, cough, and dyspnea), and/or circulatory collapse (shock). This is an extreme emergency, as the client's airway is at risk of compromise. The nurse should promptly assess the client for additional signs of anaphylaxis, notify the health care provider (HCP), and initiate interventions to stop further symptom progression while alleviating the current manifestations.

Choice A is incorrect. Nausea is likely a reaction to the administration of contrast material, presumably capable of being alleviated by the administration of a PRN (as needed) intravenous antiemetic medication. While this statement should be of concern to the nurse, this is not the priority concern. The nurse should prioritize airway-related symptoms in this client.

Choice B is incorrect. This statement by the client may indicate anxiety or a flushing sensation being experienced by the client. The nurse should address the client's concern; however, it is not prioritized over an airway-related complaint.

Choice C is incorrect. A warm, flushed feeling is a benign and anticipated reaction following the intravenous administration of contrast media. The sensation may be felt throughout the body but is often pronounced in certain regions - most clients experience this as a warm sensation around the throat, which gradually moves down to the pelvic area.

✓ Prioritization

• Airway patency falls under the physiological needs level of Maslow's Hierarchy of Needs.
• When addressing prioritization questions, physiological needs must be prioritized over all other types of needs.

✓ Contrast Agent Allergies

• Clients with the highest risk of contrast agent allergies are those with a previous history of reactions to contrast media, those taking beta-blockers, and those with heart disease, asthma, and/or renal insufficiency.
• Research shows that clients with seafood allergies are not at any additional risk if given contrast media.
• Additionally, clients with allergies to topical iodine preparations or other iodides are also not at increased risk for contrast media reactions.

✓ Prevention of Contrast Agent Allergies

• To prevent contrast media allergies, a prednisone or diphenhydramine medication regimen can often be utilized in clients with a previous history of a contrast allergy.
• If possible, the risk of contrast reactions can be reduced using nonionic contrast media instead of ionic contrast media.