Transcript Chapter 17
Chapter 14 Intravenous Iodinated Contrast Why use IV Contrast • ____________ System • ___________ System • _______ Terms to know • ____________ – To separate into ions; to dissociate atoms or molecules into electrically charged atoms • ____________ – The capability of being dissolved More Terms • ____________ – Movement of a solvent across a semipermiable membrane from a lower region to a higher region • ___________ – The number of dissolved ions in a solution. The concentration of a solution. • ___________ Pressure – The force that a dissolved substance exerts on a semipermeable membrane. More Terms • ____________ No change in cell volume. – • ______________ – Increase in osmotic pressure. • ______________ – Decrease in osmotic pressure • ______________ – The ability of a fluid to flow easily Iodinated Contrast • ______________ • 2 types – Ionic and Non-ionic Ionic Contrast Basic Structure • 6 sided ring: – 3 ________ atoms • __________ element – __________ • Negative charged – Stabilize and detoxify – ___________ • Positive charge – Salt, increase solubility Ionic Contrast • Breaks apart into _____________ – Anion – Cation • __________– Ratio – _________particles – _________particles Ionic Continued • Increase ______________ • Increase ____________Pressure • Hypertonic • ___________ chance of a reaction Non-Ionic • Same basic structure • Replaces ____________with ____________elements. Non-Ionic Contrast • _____________break apart. • Decreased ____________ – __________ chance of a reaction • __________ – Ratio Prior to injecting • GET AN _________________________!!! • Thorough history needs to be obtained – – – – – – – – Any allergies ____________ sensitivity Sickle Cell Kidney problems (Stones don’t count) ______________, hay fever Prior reaction with X-ray contrast Diabetic On ___________ Prior to Injecting Con’t • BUN and Creatinine levels: – Creatinine - ______________ – BUN – _______________ If there are contraindications • Notify ____________ • May still be possible with prep. Drawing up the contrast • Review your ‘6’ rights – ________ – Drug – __________ – Route – ___________ – Documentation Common feelings • During injection – ____________feeling (due to osmotic events) – ____________ taste – Nausea • Watch for _____________ Reactions • Generally happen within first __________. • Stay with the patient at a minimum ______________ • ________ with the patient and watch for any signs. Reaction Categories • Mild - ___________ Effect • Moderate - ___________ Reaction • Severe - ___________Reaction • Organ Specific Vasomotor Effect Mild • Technologist _________ – Anxiety – Nausea / Vomiting – Mild, scattered Hives (uticaria) – Lightheaded – _____________ – Extravasation • Symptoms pass ___________ Anaphylactic Mild or Moderate • Technologist ____________ – Excessive urticaria (hives) – ___________ – Laryngospasm – Bronchospasm – _____________ – Hypotension – Excessive ___________ Vasovagal Severe • Technologist ______________!!!!!!!! – – – – – – – – – Hypotension ______________ Cardiac or respiratory arrest Loss of consciousness _________________ Laryngeal edema ________________ Difficulty Breathing Shock Organ-Specific Severe • • • • • Cardiac – ___________ Respiratory - Pulmonary Edema Vascular - Thrombosis Nervous - _____________ Renal - Complete or Temporary failure • ____________show immediate symptoms Prepare for a reaction • Make sure informed consent is signed • Approx _________________die – Current practice uses __________ only decreasing the chance • Know reaction protocol in department Preperation • Know where the _________is and have it accessible. • _____________leave the patient alone • If need be _________________ Post injection • Monitor pt for ______________ • Continue with exam • Normal kidney will excrete __________ of contrast within __________ What else to watch for • Kidneys will show once _________ is filtered through • A ______________contrast progression