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bontrager chapter 14
Terms in this set (127)
Which term describes an abnormal drop of the kidneys when the patient is placed erect?
The total capacity for the average adult bladder is ___
Uses a parent compound of benzoic acid.
Will not significantly increase the osmolality of the blood plasma
Incorporates sodium or meglumine to increase solubility of the contrast media.
Creates a hypertonic condition in the blood plasma.
Is more expensive.
Produces less severe reactions.
Is a near-isotonic solution.
Poses a greater risk for disrupting homeostasis.
Uses a parent compound of an amide or glucose group.
May increase the severity of side effects.
What compound is a common anion found in ionic contrast media?
Diatrizoate or iothalamate
Any disruption in the physiologic functions of the body that may lead to a contrast media reaction is the basis for the ______
An expected outcome to the introduction of contrast media is described as a
The normal creatinine level for an adult should range between
0.6 and 1.5 mg/dL
Normal BUN levels for an adult should range between
8 and 25mg/100 mL
Metformin hydrochloride is a drug that is taken for the management of ______
The american college of radiology recommends that metformin be withheld for ________________hours after a contrast medium procedure in patients with known acute renal injury, stage IV or V renal disease, or an estimated glomerular filtration rate of <30 and resumed only if kidney function is again determined to be within normal limits.
The leakage of contrast media from a vessel into the surrounding soft tissues is called ______
List the two general categories of contrast media reactions.
Local and systemic
Which type of reaction is a true allergic response to iodinated contrast media?
Which type of reaction is caused by the stimulation of the vagus nerve by the introduction of a contrast medium, which causes heart rate and blood pressure to fall?
Are vasovagal reactions considered to be life threatening?
Bradycardia (<50 beats/min) (symptom severity)
Tachycardia (>100 beats/min) (symptom severity)
Angioedema (symptom severity)
Lightheadedness (symptom severity)
Hypotenstion (systolic blood pressure <80 mm Hg) (symptom severity)
Temporary renal failure (symptom severity)
Laryngeal swelling (symptom severity)
Cardiac arrest (symptom severity)
Mild hives (symptom severity)
__________________ reactions do not usually require medication or medical assistance.
Mild-level contrast media
Urticaria is the formal term for _____
A temporary failure of the renal system is an example of a _______ reaction
Convulsion (contrast media reaction)
Metallic taste (contrast media reaction)
Angioedema (contrast media reaction)
Bradycardia (contrast media reaction)
Itching (contrast media reaction)
Vomiting (contrast media reaction)
Temporary hot flash (contrast media reaction)
Respiratory arrest (contrast media reaction)
Pulmonary edema (contrast media reaction)
Extravasation (contrast media reaction)
Severe urticaria (contrast media reaction)
What should the technologist do first when a patient is experiencing either a moderate or a severe level contrast media reaction?
Call for medical assistance
What is the primary purpose of the premedication procedure before an iodinated contrast media procedure?
To reduce the severity of contrast media reactions
Which of the following drugs is often given to the patient as part of the premedication procedure?
c. combination of Benadryl and prednisone
e. your face
c. combination of benadryl and prednisone
Which type of patient is a likely candidate for the premedication procedure before a contrast media study?
a. Elderly patient
b. Asthmatic patient
c. Pediatric patient
d. patient with hypertension
b. asthmatic patient
In addition to notifying a nurse or physician when contrast media have extravasated into the soft tissues, what should the technologist first do to increase reabsorption?
Elevate the affected extremity and use a cold compress followed by a warm compress
T/F Tissue inflammation from extravasated contrast media peaks 1-2 hours after the incident.
False - 24-48 hours
T/F Acute renal failure may occur 48 hours after an iodinated contrast media procedure.
10 contraindications that may prevent a patient from having a contrast media procedure:
A. Hypersensitivity to iodinated contrast media
C. Multiple myeloma
D. Diabetes mellitus
E. Severe hepatic or renal disease
F. Congestive heart failure
H. Sickle cell anemia
I. Patients taking metformin or similar medication
J. Renal failure, acute or chronic
A trademark name for a diuretic drug is
Why is the term IVP incorrect when describing a radiographic examination of the kidneys, ureters and badder after the intravenous injection of contrast media?
An IVP is only a study of the renal pelvis, pyelo-
What is the correct term and correct abbreviation for the examination of kidneys, ureters, and bladder after the intravenous injection of contrast media?
Intravenous urogram (IVU)
Which specific aspect of the kidney is visualized during an IVU?
The collecting system of the kidney (minor and major calyces, renal pelvis and proximal ureters)
Which condition is a common pathologic indication for an IVU?
Which condition is described as a rare tumor of the adrenal gland?
Presence of gas in urine
Backward return flow of urine
Excess urea and creatinine in the blood
Complete cessation of urinary secretion
Passage of a large volume of urine
Act of voiding
Inability to void
Diminished amount of urine being excreted
Presence of glucose in urine
Constant or frequent involuntary passage of urine
Absence of a functioning kidney
Indicated by presence of uremia, oliguria, or anuria
Acute renal failure (ARF)
Enlargement of the prostate gland
Benign prostatic hyperplasia (BPH)
Fusion of the lower poles of kidneys during development of the fetus
Inflammation of the capillary loops of the glomeruli of the kidneys
Artificial opening between the urinary bladder and aspects of the large intestine
Increased blood pressure to the kidneys resulting from atherosclerosis
Normal kidney that fails to ascend into the abdomen but remains in the pelvis
Multiple cysts in one or both kidneys
Polycystic kidney disease
Rapid excretion of contrast media
Mucosal changes within bladder
Bilateral, small kidneys with blunted calyces
Chronic Bright Disease
Irregular appearance of renal parenchyma or collecting system
Renal cell carcinoma
Signs of abnormal fluid collections
Abnormal rotation of the kidney
Elevated or indented floor of bladder
BPH (Benign prostatic hyperplasia)
Signs of obstruction of urinary system
A condition characterized by regions or areas of subcutaneous swelling caused by an allergic reaction to food or drugs is termed ______
Contraction of the muscles within the walls of the bronchi and bronchioles, producing a restriction of air passing through them, is a condition called _____
Loss of consciousness resulting from reduced cerebral blood flow is termed _____
An eruption of wheals (hives) often caused by a hypersensitivity to food or drugs.
What type of renal calculi is often associated with chronic urinary tract infections?
The patient should void before an ______ to prevent possible rupture of the bladder if compression is applied.
What is the primary purpose of ureteric compression?
To enhance filling of the renal pelvic calyces
List the six conditions that could contraindicate the use of ureteric compression
A. Possible ureteric stones
B. Abdominal mass
C. Abdominal aortic aneurysm
D. Recent abdominal surgery
E. Severe abdominal pain
F. Acute abdominal trauma
When does the timing for an IVU exam start
At the start of injection of contrast media
List the routine five step imaging sequence for a routine IVU
A. 1-minute nephrogram or nephrotomography
B. 5-minute full KUB
C. 10- to 15-minute full KUB
D. 20-minute posterior R and L oblique positions
E. Postvoid (prone PA or erect AP)
What is the primary difference between a standard and hypertensive IVU?
A hypertensive IVU requires a shorter time span between projections
In which department are most retrograde urograms performed?
Surgery (inpatient or outpatient)
T/F A retrograde urogram examines the anatomy and function of the pelvicaliceal system.
False - it does not examine the function
T/F The Brodney clamp is used for male and female retrograde cystourethrograms.
False - only male
Which of the following involves a direct introduction of the contrast media into the structure being studied?
a. Retrograde urogram
b. Retrograde cystogram
c. Retrograde urethrogram
d. All of the above
d. All of the above
Which of the following alternative imaging modalities is NOT routinely used to diagnose renal calculi?
a. Nuclear medicine
c. Magnetic Resonance Imaging
d. Computed Tomography
c. Magnetic Resonance Imaging
T/F Urinary studies on pediatric patients should be scheduled early in the morning to minimize the risk for dehydration.
T/F The number of retrograde urography procedures for urethral calculi has been reduced as a result of the increased use of CT.
Exposure factors used during a CT procedure can be adjusted to compensate for a decrease or increase in body size according to ___________ and ____________.
height and weight
T/F A patient does not require extensive bowel preparation before a CT scan for renal calculi.
Which imaging modality is used to detect subtle tissue changes following a renal transplant?
T/F Nuclear medicine is highly effective in demonstrating signs of vesicoureteral reflux.
How will an enlarged prostate gland appear on a postvoid radiograph taken during an IVU?
It will indent the floor of the bladder
Where should the pneumatic paddle be placed for the ureteric compression phase of an IVU?
Just medial to the ASIS and lateral to the spine, placed over the outer pelvic brim
What can be done to enhance filling of the calyces of the kidney if ureteric compression is contraindicated?
Place the patient in a 15 degree angle Trendelenburg position
A retrograde pyelogram is primarily a nonfunctional study of _______________________________.
the renal pelvis, major and minor calyces of the kidneys
What are the four reasons a scout projection is taken before the injection of contrast media for an IVU?
A. Verify patient preparation
B. Determine whether exposure factors are acceptable
C. Verify positioning
D. Detect any abnormal calcifications
What specific anatomy is examined during a retrograde ureterogram?
Primarily the ureters
T/F There is a change in SID recommendations when placing a patient erect versus supine for an IVU AP projection.
Which specific position is recommended for a male patient during a voiding cystourethrogram?
30 degree RPO
What kV range (analog and digital) is recommended for an IVU?
70-75 analog and 80 +/-5 for digital
Nephrotomograms produced during an IVU most commonly use an exposure angle of
How many tomograms (or focal levels) are usually produced during a routine IVU?
3 tomograms or focal levels
At what stage of an IVU is the renal parenchyma best seen?
Within 1 minute after injection
Where is the CR centered for a nephrotomogram?
Midway between the xiphoid process and the iliac crest
Which specific position, taken during an IVU, places the left kidney parallel to the IR?
How much obliquity is required for the LPO/RPO projections taken during an IVU?
Which position best demonstrates possible nephroptosis?
What CR angle is used for the AP projection taken during a cystogram?
10 to 15 degrees caudad
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