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contrast agents w11
| Question | Answer |
|---|---|
| movement of water accross a semipermeable membrane | osmosis |
| number of milliosmole per kilogram of water | mOsm/kg |
| concentration of osmotically active particles in solution | osmolality |
| high osmotic agents ... | attract water |
| examples of ionic contrast agents | conray, hypaque, renografin |
| two key points with ionic contrast agents | high osmolality, higher risk of complications |
| two key points with nonionic contrast agents | low-osmolality, lower risk of complications |
| what is a downfall of nonionic contrast agents | more expensive |
| what are three examples of nonionic contrast agents | omnipaque, isovue, optiray |
| what determines ionic vs nonionic | presence of salt; ionic has salt |
| what if the atomic number of barium | 56 |
| what is the atomic number of iodine | 53 |
| radiopaque will show up on imaging with _ contrast | positive |
| radiolucent with show up on imaging with _ contrast | negative |
| contrast excretion is primarily done through the _ | kidneys |
| with normal kidney function 100% is excreted within _hrs | 24 |
| venous and artery has _ distribution | immediate |
| urinary system distribution with IV administration take _-_ min | 15-30 minutes |
| what is important about the blood brain barrier distribution | small amounts may be distributed into CSF |
| t/f: contrast does not penetrate teh blood brain barrier well on a patient with a normal CNS | true |
| for IVs the solution should be _-_ above the level of the vein | 18 inches (45cm)- 24 inches (60cm) |
| t/f contrast is a medication | true |
| contrast reactions occur most often either immediately or within _ min | 20 min |
| low osmolality def | low concentration of solute particles relative to the amount of solvent (diluted) |
| high osmolality def | high concentration of solute particles relative to the amount of solvent |
| viscous means | thick, hard to inject, sticky |
| which has a lower chance for potential adverse reactions | non-ionic |
| who are the patients we should use nonionic contrast for | elderly, patients with ♥ disease, diabetes, and or renal insufficiency |
| if we want to lower the viscosity what can we do | warm it |
| adverse renal effects to contrast include: | decrease in renal blood flow, tissue ischemia |
| statistic of patients who die from contrast media every year | 1 our of every 1000 |
| immediate reaction to contrast = | anaphylaxis |
| immune cells- mast cells: | become sensitized to certain antigens |
| anaphylactoid reaction: | mimics anaphylaxis, no prior exposure necessary to sensitize mast cells |
| code red = | fire |
| code silver = | active shooter |
| code grey = | loss of essential services |
| code purple = | hostage / abduction |
| code orange = | external disaster |
| code blue = | cardiac arrest |
| code green = | internal evacuaiton |
| code yellow = | missing patient |
| code black = | bomb threat |
| code brown = | chemical spill |
| code white = | violent situation |
| BUN should be | 8-25 |
| creatinine should be | 0.6-1.5 |
| what medication should be held with contrast | metformin |
| inflammation of a vein is termed | phlebitis |
| what are the signs and symptoms of phlebitis | pain, tenderness, warmth, lump |
| who are at higher risk for extravasation | small children, elderly, unconscious (cannot respond to burn) |
| what should you do if you suspect extravasation | STOP IMMEDIATELY |
| what are some signs of acute kidney injury | creatinine increases 24-48 hours, peaks at 3-5 days, returns to baseline 7-10 days |
| in more severe cases of AKI the peak is not seen until | 7-10 days |
| renal ischemia is | lack of oxygen to kidney tissue |
| intratubular obstructions could be caused by | proteins, uric acid, calcium oxalate/kidney stones |
| risk factors for AKI | diabetes, dehydration, age, poor renal blood flow, certain medications, |
| hold metformin _ hours post procedure | 48 |
| control blood pressure is | 120/80 mmHg |
| you should check renal function _-_ hours following the procedure | 48-72 |
| mild reactions would include | limited urticaria(hives), rhinorrhea (runny nose), conjuncitivis, sneezing, nasal congestion, |
| moderate reactions would include | |
| severe reactions would include | |
| temperature for an adult should be | 97.8-99 |
| a childs temperature should be | |
| infant temperature should be | |
| most accurate temperature is taken where | rectal |
| adult pulse should be | 60-90 bpm |
| anything over 90 bpm would be termed | tachycardia |
| anything under 60 would be termed | bradycardia |
| child bpm | 90-100 |
| infant bpm | 120 |
| monitors oxygen saturatio of hemoglobin | pulse oximetry |
| what is the normal range of pulse oximetry | 95-100% |
| what is the normal respirations for adults | 15-20 breaths per min |
| what is the normal respirations for an infant | 30-60 breaths per minute |
| normal systolic range is | 90-120 |
| normal diastolic is | 50-70 |
| hypertension systolic and diastolic | sys: above 140 dia: above 90 |
| hypotension systolic and diastolic | sys: below 95 dia: below 60 |
| measures the patients blood pressure | sphygomomanometer |
| listening device (♥ or blood pressure) | stethoscope |
| permission based on situation or circumstances | implied |
| when would implied consent be used | emergency or trauma |
| when would we need written consent | high risk procedures (IV, contrast, possible allergic reactions, needles) (LP) |
| when would we used oral consent | low risk procedures such as a chest xray |
| informed consent would be from | the physician |
| patient identification includes | name, DOB, mrn |
| underweight BMI is | below 18.5 |
| normal BMI is | 18.5-24.9 |
| overweight BMI | 25-29.9 |
| obese BMI | 30-34.9 |
| extremely obese BMI | 35 + |
| threatening the patient is | assault |
| unlawful touching of the patient | battery |
| false imprisonment would include | retraining the patient without a physician order), pt refuses the exam and wants to leave |
| under _ pt medical records are kept confidential | HIPAA |
| ignoring or neglecting the patients/needs would be | negligence |
| defamation by written or printed words such as charting | libel (think libel library, keep things professional that does not insult the patient) |
| defamation by spoken words | slander |
| inTentional or uninTentional act resulting in injury - angling during the exam and accidentally hitting the patient - driving the portable and running over someone | TORT |
| exposure indicator has a _ relationship with exposure | direct |
| the s number has an _ relationship with exposure | indirect |
Created by:
macummins1