Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
AP 2 - Book
Lecture 12 - Urinary Procedures
| Question | Answer |
|---|---|
| A general term used to describe the Radiographic visualization of the Urinary Tract using contrast media | Urography |
| Type of Contrast Media used in Urinary procedures? | Water-Soluble Iodinated Contrast Media |
| Routes of Administration for a Urinary Procedure? | Intravenous Injection or Infusion through a Urinary Catheter |
| Atomic Number of Iodine | 53 |
| Advantages of using Water-soluble Iodinated contrast media? 1. 2. 3. | 1. Mixes readily with blood and body fluids 2. is absorbed and excreted by the Kidneys through the circulatory system 3. Comes in a variety of concentrations depending on the % of Iodine in the solution |
| List characteristics of Intravascular Water-Soluble Iodinated Contrast Media: 1. 2. 3. 4. 5. | 1. Iodine Content 2. Osmality 3. Concentration 4. Viscosity 5. Toxicity |
| refers to the total % of salts in a solution | Concentration |
| Measures the resistance of the flow of fluid | Viscosity |
| Disrupts homeostasis of the body and can be toxic | Toxicity |
| Refers to the contrast media's ability to absorb x-ray photons | Iodine content |
| The number of particles in the solution | Osmality |
| Questions asked when performing a patient assessment prior to injection of Intravascular Water-soluble Iodinated Contrast Media: 1. 2. 3. 4. | 1. Allergies to food/medication 2. History of Asthma 3. History of any previous Iodinated Contrast reactions 4. History of Cardiac or Renal Impairment |
| Creatinine Lab range | 0.6-1.5 mg/dL |
| GFR (Glomerular Filtration Rate) lab range | 90-120 ml/min |
| BUN (Blood Urea Nitrogen) lab range | 8-25 mg/100mL |
| Contraindications to the use of Water-soluble Iodinated Contrast Media: 1. 2. 3. 4. 5. 6. | 1. Allergy/Iodine 2. Anuria 3. High Creatinine Level 4. Renal Disease or other condition that compromise renal function 5. Congestive Heart Failure 6. Severe Dehydration |
| Side effects that may occur after an injection of Water-soluble Iodinated Contrast Media: 1. 2. | 1. Temporary Hot Flash 2. Metallic taste in mouth |
| The body's overreaction to certain triggers, such as the sight of blood or needles. | Vasovagal Syncope |
| RT Responses to a Vasovagal Syncope: 1. 2. | 1. If patient is sitting: carefully support them in a bent position with their head between their knees 2. If patient is lying down: position the patient on their back and raise their feet higher than their head, Trendelenberg Position |
| An unexpected local and/or systemic physiological response to the injection of contrast medium | Reaction |
| The majority of both types of contrast media reactions are attributed to what? | Intravenous Injections |
| Reaction that affects only the region of the body where the contrast medium has been injected (vein, skin, or lining of an organ) | Local reaction |
| Reaction that affects the entire body or a specific organ? | Systemic reaction |
| RT response to a local skin reaction to an injection | 1. watch for signs of extravasation at the injection site 2. patient may complain of numbness or burning at the injection site 3. Rad/Nurse/Tech reposition or remove the needle 4. Should be documented in patient chart |
| What produces a local reaction? | Extravasation or Infiltration of the contrast medium out of the vessel and into the surrounding tissue, "blown vein" |
| Inflamation of a vein | Phlebitis |
| Cardiac Stimulant/Bronchodilator | Epinephrine |
| Antihistamine | Benadryl |
| Vasoconstrictor | Aramine |
| Combats Acidosis | Sodium Bicarbonate |
| Cardiac Stimulant | Isuprel |
| Bronchodilator | Aminophyline |
| Vasoconstrictor | Norepinephrine |
| Parasympathetic blocker | Atropine |
| Maintains blood pressure | Solu-Cortef |
| NaCL | IV bag with Sodium Chloride |
| Adverse reactions to Water-soluble Iodinated Contrast Media are usually ______ | acute |
| The vast majority of reactions from Water-soluble Iodinated Contrast Medium will occur within the first _____ minutes after an injection | 5 |
| Systemic Contrast Media Reactions are classified as? | Mild, Moderate and Severe |
| What type of Systemic Reaction to contrast media causes: anxiety, lightheadedness, nausea, vomiting, mild erythema, itching, mild scattered hives | Mild reaction |
| RT Response to a Mild Contrast Media Reaction: 1. 2. 3. | 1. Slow, deep breathes until the nausea subsides 2. cool washcloth for the forehead 3. Reassuring patient *observe and document patient |
| What type of Systemic Reaction to contrast media causes: Urticaria (moderate to severe hives), possible laryngeal swelling, bronchospasms, tachycardia (100 bpm), Bradycardia (60 bpm), angioadema, hypotension | Moderate reaction |
| RT Response to a Moderate Contrast Media Reaction: | 1. Treatment which requires drug intervention to counter effects of the reaction 2. Monitor patients breathing and blood pressure 3. Reassure patient if they experience anxiety, heart palpitations, headache, and dizziness *observe and document patient |
| What type of Systemic Reaction to contrast media causes: life threatening response: hypotension, bradycardia (50 bpm), cardia arrhythmias, laryngeal swelling, convulsions, loss of consciousness, cardiac arrest, respiratory arrest, no detectable response | Severe reaction |
| RT response to a Severe Contrast Media Reaction: | 1. Call for HELP - check breathing and begin CPR if the patient is not responding 2. Call the Radiologist STAT and prepare to call a CODE upon his/her instructions 3. If the patient is unconscious - call CODE immediately |
| a functional examination as the contrast medium is filtered out of the kidneys and transported through the Urinary Tract as urine | IVU or intravenous urogram |
| What is visualized in a IVU or intravenous Urogram? | The entire Urinary System: Kidneys, Ureter, Urinary Bladder |
| More commonly used term when referring to a radiographic examination of the Urinary System | IVP or Intravenous Pyelogram |
| Clinical Indications for performing an IVU examination (6): | 1. Renal/Ureteral Calculi 2. Kidney trauma 3. Undetermined lower back pain 4. Abdominal/pelvic masses, tumors or renal cysts 5. Hematuria (blood in urine) 6. Recurrent UTIs |
| GI Preparation for an IVU examination (3) | 1. NPO after midnight 2. Withhold food/fluids at least 8 hours prior to exam 3. Some Dpts. - Bowel prep prior *Pediatric and emergency patients are performed without prep |
| Method used to enhance contrast filling of the the Calyces, Renal Pelvis and Proximal Ureters which allows the renal collecting system to retain the contrast media longer | Abdominal or Ureteric Compression |
| The Compression Device (Abdominal or Ureteric) consists of: 1. 2. 3. | 1. Velcro band 2. Two balloons attached to tubing 3. Puffalator |
| When is the Abdominal or Ureteric Compression Device placed? | Before the contrast media injection with the balloons deflated |
| Compression Device placement Velcro band: Balloons: Puffalator | Velcro band: initially, under patients back and then drawn across the balloons and secured over anterior abdomen Balloons: top of balloons - Iliac crest on either side of the vertebral column Puffalator: attached to blow up balloons |
| Purpose of a Compression Device in an IVU procedure | Allow the renal collecting system to retain contrast media longer |
| Contraindications for the use of Abdominal Compression during an IVU (6): | 1. Possible Ureteral Stones 2. Abdominal Mass 3. Abdominal Aortic Aneurysm (AAA) 4. Recent Abdominal Surgery 5. Acute abdominal pain/trauma 6. Quadriplegic/Paraplegic |
| A special type of imaging that is used to obtain a specific layer of tissue that is superimposed by other structures | Tomography |
| The X-ray tube and Image Receptor move in opposite directions during the exposure producing an image called a ______ | Tomogram |
| The Tomographic Equipment consists of: | 1. metal connecting arm or rod 2. a motor 3. an adjustable fulcrum indicator |
| component on Tomographic Equipment that allows the tube and bucky to move in an arch over the patient | motor |
| component on Tomographic Equipment that determines the distance from the tabletop, which determines the plane to be imaged - raises or lowers the focal point | Fulcrum Indicator |
| Image created demonstrating a clear image of an object lying in a specific plane, with blurring structures above and below the specific plane that is selected | Linear Tomogram |
| Equipment prep for an IVU (6) | 1. Clean/straighten room 2. Radiolucent pad on x-ray table with clean linen 3. Prepare tomographic equipment 4. set out injection supplies 5. 14x17 IR in bucky lengthwise 6. Prepare control panel for exposure (70-80 kVp, AEC, Large focal spot) |
| Patient Preparation for an IVU (7) | 1. Provide gown and instructions (remove everything) 2. Void prior to exam 3. Explain IVU procedure (may have hot/warm feeling, metal taste in mouth during injection) 4. Patient history, pregnancy, complete patient assessment 5. SCOUT images |
| What are the SCOUT projections performed prior to an IVU procedure? | AP - KUB (Mark R lower right corner and SCOUT lead markers) AP Tomogram |
| Timed Routine includes: | 1. 3 Tomograms - immediately after injection 2. 5 minute cone-down of kidneys 3. 10 minute KUB with compression 4. 12 minute KUB post-compression release 5. Post Void KUB |
| Post exam procedure performed at the conclusion of an intravenous urogram (IVU) | 1. images reviewed by Radiologist 2. if no further imaging requested patient may leave 3. typically no post-exam instructions 4. IVU findings will be discussed with patient by patients primary physician |
| What is difference between a routine IVU and a Hypertensive IVU? | A Hypertensive IVU is performed to rule out secondary hypertension due to Renal Arterial Stenosis |
Created by:
teresachristensen
Popular Radiology sets