Prior to an excretory urography for a client with type 2 diabetes, what should the nurse do?

Withholding metformin for 24 hours prior to an excretory urography is critical for a client with type 2 diabetes, particularly due to the potential for contrast-induced nephropathy. Metformin, when combined with intravenous contrast agents, has been associated with an increased risk of lactic acidosis, especially in individuals with compromised kidney function.

By withholding metformin, the risk of this complication is minimized. It is standard practice to ensure that renal function is adequate before administering contrast dye, and delaying metformin allows the kidneys to recover from the effects of the contrast, should any temporary changes in renal function occur. Regular monitoring of renal function and timely cessation of metformin when procedures involving contrast are planned are essential nursing interventions in this scenario.

While encouraging increased fluid intake is generally a good practice to help flush out the contrast dye and promote renal function, it is not as specifically crucial as managing metformin use. Other options, such as performing a complete blood count, do not directly address the primary concern related to metformin and renal safety during excretory urography.