Following CT contrast, which finding requires the nurse to intervene first?

• A. Vomiting
• B. Stridor
• C. Urticaria
• D. Hypotension

Answer: (B)

Airway protection is the highest priority when a patient has a hypersensitivity reaction to IV contrast. Stridor signals upper airway involvement from edema and possible bronchospasm, which can rapidly progress to life-threatening airway obstruction and hypoxia. Because breath control and oxygen delivery are essential for survival, addressing airway compromise comes before other symptoms like skin reactions or hypotension.

Vomiting, while uncomfortable and potentially risky due to aspiration, does not indicate an immediate airway threat. Urticaria shows a systemic allergic reaction but, by itself, does not imply acute airway blockage. Hypotension is dangerous and requires prompt treatment, but with stridor present, securing the airway takes precedence to prevent respiratory collapse. In practice, this means prioritizing actions to maintain airway patency and provide emergency care for anaphylaxis if indicated, followed by other supportive measures.