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RT 208 > 5.2 Contrast Agents Part 2 > Flashcards

5.2 Contrast Agents Part 2 Flashcards

1
Q

a very small percentage less than ____ of the iodinated CM given to a mother will be excreted into breast milk and absorbed by the infant

A

1%

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2
Q

one of the most widely used and one of the safest of all medications

A

Iodinated contrast agents

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3
Q

are extremely rare in both HOCM and LOCM estimated at 0.9 per 100,000 (<0.001%)

A

Fatal reactions

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4
Q

Mechanisms of Adverse Reactions

A
  • Contrast Reaction

- Subjective Effects

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5
Q

all undesired effects including the many subjective side effects experienced to some degree by most patients to whom contrast is administered

A

Contrast Reaction

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6
Q

feeling of heat, nausea and mild flushing

A

Subjective Effects

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7
Q

2 Categories of Reactions

A
  1. Chemotoxic Reactions

2. Idiosyncratic Reactions

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8
Q

result from the physiochemical properties of the contrast media, the dose, and speed of infection

A

Chemotoxic Reactions

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9
Q

all hemodynamic (blood circulation) disturbances and injuries to organs

A

Chemotoxic Reactions

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10
Q

Chemotoxic Reactions examples

A

Contrast-induced nephropathy

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11
Q

includes all other reactions

A

Idiosyncratic Reactions

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12
Q

largely unpredictable

A

Idiosyncratic Reactions

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13
Q

most often occur within 1 hour of CM administration and are not related to the dose

A

Idiosyncratic Reactions

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14
Q

symptoms resemble allergic (or anaphylactic) and are therefore, often called “allergic-like” or “anaphylactoid” reactions

A

Idiosyncratic Reactions

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15
Q

risk of recurrent reaction in a patient with a prior reaction:

A

HOCM - 16% to 35%

LOCM - 7%

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16
Q

Common side effects:

“Less common when LOCM is used”

A
  1. Nausea
  2. Vomiting
  3. Altered taste (often described as metallic)
  4. Perspiration
  5. Warmth
  6. Flushing
  7. Anxiety
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17
Q

Classifications of Idiosyncratic Reactions

A
  • Mild
  • Moderate
  • Severe
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18
Q

short duration and self-limiting

A

Mild

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19
Q

monitor patient at least 20-30 mins (M-S)

A

Mild

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20
Q
  • Cough
  • Itching
  • Pallor (pale)
  • Rash (hives)
  • Nasal stiffness
  • Minimal swelling in the eyes and face
  • Facial rash
A

Mild

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21
Q

not immediately life threatening

A

Moderate

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22
Q
  • Respiratory difficulties (bronchospasm, dyspnea, wheezing, laryngeal edema)
  • Pulse change
  • Hypertension
  • Hypotension (leg elevation)
A

Moderate

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23
Q

potentially/immediately life-threatening

A

Severe

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24
Q
  • Substantial respiratory distress
  • Unresponsiveness
  • Convulsions
  • Clinically-manifested arrhythmias
  • Cardiopulmonary arrest
A

Severe

25
Q

Treatment

A

ABC

Airway Assessment, Breathing and Circulation

26
Q

Treatment is Followed by

A

ACLS

Advanced Cardiac Life Support Treatment

27
Q

Majority of idiosyncratic adverse side effects are mild, non-life-threatening events that require only ____

A

observation, reassurance and support

28
Q

HOCM percentage of side effects

A

5 to 12% (Mild-98% to 99%)

29
Q

The Radiographer may assist in reducing anxiety in the following ways:

A
  1. Assessment of the patient’s understanding of the procedure
  2. Informing the patient in detail concerning how the examination will proceed
  3. Explanation of the expected side effects and assurance that these are not unusual
  4. Allowing the patient to express feelings of anxiety and obtaining patient feedback to ascertain his complete understanding of the procedure
30
Q

Patient Assessment Prior to Administration of Contrast Medium (1)

A
  1. Patient’s age
  2. History of impaired hepatic function
  3. History of impaired renal function
  4. History of allergic or anaphylactic reactions
  5. History of thyroid disease
  6. Last menstrual period and possible pregnancy
  7. Nursing mother
  8. Sensitivity to aspirin
31
Q

Patient Assessment Prior to Administration of Contrast Medium (2)

A
  1. History of diabetes mellitus
  2. History of sickle cell disease
  3. History of hypertension
  4. History of pheochromocytoma
  5. History of seizures
  6. Medication history
  7. History of previous reactions to medications or contrast agents
  8. Allergy to seafood
32
Q

Incidence and Risk Factors for Idiosyncratic Reactions

A
  1. Previous contrast medium reaction
  2. Asthma
  3. Allergies
  4. Drugs
33
Q

Prevention of Acute Idiosyncratic Reactions

A
  1. Use LOCM
  2. Role of premedication
  3. Documentation
  4. Renal anatomy and physiology
34
Q

most important method of reducing the risk of idiosyncratic CM reaction

A

Use LOCM

35
Q

pretreatment with steroids will reduce the rate of idiosyncratic CM

A

Role of premedication

36
Q

adverse reaction to CM administration must be appropriately documented

A

Documentation

37
Q

Elements that must be captured:

A
  1. Amount and type of contrast injected
  2. Signs and symptoms of the reaction
  3. Interventions or medications given during the reaction and patients response to treatment
  4. Final outcome (discharged or admitted)
38
Q

paired organs that lie behind the parietal peritoneum

A

Renal anatomy and physiology

39
Q

level of T12-L3

A

Renal anatomy and physiology

40
Q

0.5% of total body weight, receives ____ of total arterial blood

A

20-25%

41
Q

contains _____ nephrons per kidney

A

1-2M

42
Q

the ability of the kidney to remove a substance from the blood

A

Clearance

43
Q

volume of plasma that is cleared of a specific substance in a given time

A

Clearance

44
Q

GFR

A

Glomerular Filtration Rate

45
Q

Glomerular Filtration Rate (GFR)

A

60-120 mL/min (normal),
16-59 mL/min (kidney disease),
0-15 mL/min (kidney failure)

46
Q

ERPF

A

Effective Renal Plasma Flow

47
Q

Effective Renal Plasma Flow (ERPF)

A

500 mL/min

48
Q

used for the estimation of GFR

A

Inulin

49
Q

ideal filtration marker

A

Inulin

50
Q

metabolically inert (not digested or absorbed in the stomach)

A

Inulin

51
Q

cleared only by kidney

A

Inulin

52
Q

demanding and time-consuming

A

Inulin

53
Q

index of GFR

A

Serum Creatinine

54
Q

a by-product of muscle protein metabolism generated by the body at a fairly steady rate and excreted entirely in the urine

A

Creatinine

55
Q

Female Creatinine level

A

0.5 - 1.1

56
Q

Male Creatinine level

A

0.6 - 1.0

57
Q

Creatinine clearance test can be done using samples from _________ & _______

A

blood, urine

58
Q

Methods to measure creatinine or kidney function

A

Effective Renal Plasma Flow,

Glomerular Filtration Rate

59
Q

produces urine by filtering out from the blood small molecule and ions and then reclaiming the needed amount of useful materials

A

Nephron

RT 208 (16 decks)

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