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AP 2 - Book
Lecture 12 exam study - Urinary Procedures
| Question | Answer |
|---|---|
| A general term used to describe the radiographic visualization of the Urinary Tract using contrast media | Urography |
| Contrast Medium used to visualize the Urinary System | Water-Soluble Iodinated Contrast Media |
| Routes of Administration for Urography procedures: 1. 2. | 1. Intravenous injection 2. Infusion through a Urinary Catheter |
| Atomic number of Iodine? | 53 |
| Why is Iodine used in water soluble contrast media? | Because it forms stable compounds and can image all systems of the body including the Digestive System |
| Advantages of 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 |
| refers to the contrast media's ability to absorb x-ray photons | Iodine Content |
| The number of particles in solution | Osmolality |
| The osmolality of a contrast media is directly related to? | The occurrence of adverse reactions |
| The higher the osmolality - the ______ the chance for an adverse contrast media reaction. | Greater |
| Refers to the total % if salts in solution | Concentration |
| Contrast media is frequently warmed to ____ ______ to reduce viscosity, making it easier to inject | body temperature |
| This disrupts homeostasis of the body and can be toxic - related to the contrast medium's chemical configuration, osmolality, iodine concentration and rate of injection (how fast it enters the bloodstream) | Toxicity |
| Adverse reactions to Water-Soluble Contrast Media are usually _____ and the vast majority of reactions will occur within the first _____ minutes after injection | Acute; 5 |
| Two types of Water-Soluble Iodinated Contrast Media: | 1. Ionic 2. Non-Ionic |
| Similarities between the two types of Water-Soluble Iodinated Contrast Media? | Both contain Iodine as the radiopaque element and are absorbed by the body and excreted by the Kidneys |
| Differences between Water-Soluble Iodinated Contrast Media: 1. Ionic form ______ ______ _____ within the cells of the body 2. Non-Ionic form _____ _____ ____ within the body | 1. Creates chemical bonds 2. Doesn't chemically bond |
| Non-Ionic Iodinated Contrast Media has a ______ osmolality | lower |
| Non-Ionic Iodinated Contrast Media is considered _______ because the molecules do not form ionic bonds when mixed with blood plasma | Isotonic |
| Non-Ionic Iodinated Contrast Media is used almost exclusively in place of Ionic Contrast because of ______ toxicity. | lower |
| Prior to injection of Water-Soluble Iodinated Contrast Medium, a thorough patient history is conducted to include: 1 2 3 4 | 1. Allergies to food/medication 2. Allergies/previous reactions to Iodinated contrast media 3. History of Asthma 4. History of Cardiac or Renal Impairment |
| What is reviewed prior to the use of Injectable Water-Soluble Iodinated Contrast Medium? | The most current Creatinine, GFR and/or BUN Laboratory results |
| Elevated BUN and Creatinine laboratory findings indicate what? | Acute or Chronic Kidney Failure |
| Glomerular Filtration rate (GFR) ___-___ mL/minute is considered normal, below ___ mL/minute indicates Kidney Failure | 60-120; 15 |
| Contraindications to Water-Soluble Iodinated Contrast Medium Contraindications: 1-6 | 1. Allergy/hypersensitivity to iodine 2. Anuria 3. Severe Dehydration 4. High Creatinine 5. Renal disease, or other impairment that causes renal function 6. Congestive Heart Failure |
| Drug given to manage non-insulin dependent diabetes mellitus | Metformin |
| The American College of Radiology recommends that Metformin be withheld _____ hours after an Iodinated contrast procedure and only resumed if kidney function is within _____ limits. (the combo can induce acute renal failure) | 48; Normal |
| Expected responses (side effects) from contrast media: | Temporary hot flash and/or Metallic taste in Mouth |
| Response that occurs as a result of anxiety or fear, the body overreacts to certain triggers such as the sight of blood or needles? | Vasovagal Syncope |
| RT response to a Vasovagal Syncope response to Water-soluble contrast media? | 1. Cold wet washcloth on face or neck 2. If cold to touch, cover with blanket 3. Notify Radiologist or Nurse 4. Prepare blood pressure equipment |
| An unexpected physiological response to the injection of contrast medium? | Local and/or systemic |
| 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 |
| Contrast Medium out of the vessel and into the surrounding soft tissue which may produce a local reaction from the contrast medium at the injection site | Extravasation or Infiltration |
| RT response to a local reaction to contrast media? | 1. needle repositioned or removed and alternate site located for injection 2. warm towel placed over injection site 3. documented in patient's chart |
| Reaction that affects the entire body or a specific organ system | Systemic reaction |
| System Reactions are classified as? | Mild, Moderate, and Severe |
| Metallic taste in mouth, hot flashes, nausea, and vomiting are classified as what type of reaction? | Mild Reaction |
| Urtiaria (hives), wheezing, hypotension, tachycardia, and facial edema are classified as what type of reaction? | Moderate Reaction |
| Anaphylactic Shock, Respiratory Distress, and Respiratory/Cardiac Arrest are classified as what type of reaction? | Severe Reaction |
| What type of reaction is associated with the Molecular Toxicity Theory of why contrast media reactions occur? | Anaphylactic Reaction |
| Usually self-limiting, NOT requiring medication for relief of symptoms. | Mild reaction to contrast media |
| Reaction to contrast media that produces excessive Urticaria - Large patches of hives that are spreading? | Moderate Reaction |
| How is Urticaria treated? | With an injection of a Antihistamine |
| Anaphylaxis (allergic reaction) is treated with what? | An injection of Epinephrine |
| Characteristics include: Vasoconstrictor, Decreases mucosal edema (relieving upper airway obstruction), increase blood pressure (preventing and relieving shock), Adrenergic effects, and decreases the release of histamine and other inflammatory responses | Epinephrine |
| Epinephrines generic name? | Adrenalin |
| RT actions to moderate response: | Call Radiologist and nurse, prepare injection supplies, draw up med, monitor |
| A life-threatening reaction to contrast media? | Severe reaction |
| What organ systems can a severe reaction to contrast media affect? | Cardiac, Respiratory, Vascular, Nervous, Renal |
| Severe reaction response from the Cardiac System to contrast media? | Pulseless electrical activity |
| Severe reaction response from the Respiratory System to contrast media? | Pulmonary edema |
| Severe reaction response from the Vascular System to contrast media? | Venous thrombosis |
| Severe reaction response from the Nervous System to contrast media? | Seizure |
| Severe reaction response from the Renal System to contrast media? | Acute (temporary) Renal Failure |
| RT response to severe reaction to contrast media? | Call for help, check breathing, begin CPR (if patient not responding), all radiologist STAT and prepare to call CODE upon his/her instruction, if patient is unconscious, call a code immediately |
| A radiographic examination of the Urinary System with contrast media, also referred to as an IVP (Intravenous Pyelogram) | IVU (Intravenous Urogram) |
| Intravenous Urogram/Pyelogram clinical indications: | Renal/Ureteral Stones, trauma, lower back/flank pain, Abdominal/Pelvic masses, tumors, cysts, Hematuria, recurrent UTI |
| GI Prep for Intravenous Urogram/Pyelogram: | NPO after midnight food and fluid withheld at least 8 hours Pediatric and emergency patients - without prep |
| 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 (tomography) producing an image called? | Linear Tomogram |
| When images are taken at specific after the Intravenous Urogram/Pyelogram injection to visualize the kidneys at various stages of filtration and drainage of the contrast medium | Imaging Sequence |
| Normal venipuncture site for an IVU is what vein in the forearm? | Antecubital vein |
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teresachristensen
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