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Urinary System-rg13

Why do we perform contrast studies on the urinary system? To demonstrate the renal parenchyma using contrast media followed by x-ray or CT imaging
What are the 2 filling techniques used in Urinary Studies? Antegrade—with the normal pathflow & Retrograde—against the normal pathflow
The_____filling technique demonstrates ______ & is usually administered thru the _______. Antegrade, function & structure, bloodstream
The _____filling technique typically demonstrates _____ & is used to demonstrate ______. Retrograde, blockage, structure
Imaging of the renal drainage & collecting system is called____ Urography
Urography is a functional study--True/False True (it looks at how the renal system drains)
What studies are considered antegrade urographic studies? Intravenous Urography (IVU) Pyelography (old=IVP) Nephrotomography (before CT due to obliquity) Nephrourography-images after contrast injected into veins
Describe how a retrograde urograph is performed: by introducing contrast against the normal flow via ureteral or urethral catheterization
Which study is an excretory technique? The IVU--Intravenous Urography
What is demonstrated by a Pyelography study? The renal pelvis & calyces
Why are lower contrast concentrations used in bladder studies? Due to the large amount required to fill the bladder.
What type of contrast do we use to reduce adverse reactions? NonIonic Iodinated Media
What are the 3 categories of adverse reactions to contrast? Mild, moderate, & severe
List Mild adverse reactions to Contrast Sensation of warmth, sneezing, flushing, metallic taste, a few hives
List Moderate adverse reactions to Contrast Nausea, vomiting, itching, (edema of respiratory mucous membranes)
List Severe adverse reactions to Contrast Respiratory Edema, Anaphylactic reactions, cardiac/respiratory crisis
What are 4 things we do to reduce chances of adverse reactions? 1. Fully Assess prior to administering contrast. 2. check history carefully--include food/meds (all)allergies (shellfish), 3. Have crash cart, O2,& suction ready 4. Do Not leave Patient alone 1st 5 min.
What should be included in patient assessment before administering contrast? 1. hx. of allergies 2. current meds 3. surgical procedures (for venipunture site) 4. Past/Current disease processes 5. Lab values for BUN & Creatinine
When should you verify IV Contrast? 1. Before prep 2. During Prep 3. Before Admin (all)
Why should you inject air into the contrast vial prior to drawing? Reduce air bubbles in the syringe
Since a bowel prep is not attempted on children/infants, what can be done to better visualize their urinary tracts? Give them a carbonated beverage to distend stomach. Pushes intestinal loops inferiorly, allows upper irinary tracts to be better visualized.
Clear demonstration of the urinary tract requires what prep of the intestinal tract The instestinal tract must be free of gas & fecal matter: low residue diet 1-2 days prior Lt. evening meal day prior non-gas laxative day before(as needed) NPO after midnight Need to be WELL HYDRATED (H2O)
What types of patients have a higher risk of contrast induced renal failure if dehydrated? Diabetics, Multiple Myeloma High Uric Acid Levels
What is the normal BUN range & when is it contrainindicated? 5-21 range over 65
What is the normal Creatinine range & when is it contrainindicated? 0.6-1.0 range over 1.6
Is a full prep required for a lower urinary tract study? No--just looking at the bladder
How much H20 should one drink a few hours prior to a retrograde exam? 4-5 cups to decrease dehydration chances
Why is compression used in excretory urography (IVU)? To retard the flow into the bladder ensuring the renal pelvis & calyces get filled
Where is Compression centered when used? Over the level of the ASIS
What can be used in place of compression with somewhat same results/less risks? 15 degree Trendelenburg
When is Ureteral Compression contrainindicated? urinary stones abdominal masses aortic aneurysm colostomy suprapubic catheter traumatic injury
Created by: RadGirl13