Ch. 14 Urinary System and Venipuncture Workbook Flashcards
1
Q
which specific position, taken during an IVU, places the left kidney parallel to the IR
A
RPO
2
Q
any disruption in the physiologic functions of the body that may lead to a contrast media reaction is the basis for what theory
A
chemotoxic theory
3
Q
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
A
vasovagal reaction
4
Q
a large stone that grows and completely fills the renal pelvis
A
staghorn calculus
5
Q
how much obliquity is required for the left/right posterior oblique projections taken during an IVU
A
30 degrees
6
Q
which position best demonstrates possible nephroptosis
A
erect position
7
Q
where are the kidneys and ureters located in relation to the peritoneum
A
retroperitoneal
8
Q
at what stage of an IVU is the renal parenchyma best seen
A
within 1 minute after injection
9
Q
T/F - contrast media should never be injected into the bladder under pressure but should be allowed to fill slowly by gravity in the presence of an attendent
A
true
10
Q
T/F - vasovagal reactions are not considered to be life threatening
A
false
11
Q
where is the CR centered for a nephrotomogram
A
midway between xiphoid and iliac crest
12
Q
what category of systemic contrast media reaction results in temporary renal failure
A
severe
13
Q
what category of systemic contrast media reaction results in bradycardia (<50 beats/min)
A
severe
14
Q
what CR angle is used for the AP projection taken during cystogram
A
10-15 degrees caudad
15
Q
what type of patient is a likely candidate for the premedication procedure before a contrast media study
A
asthmatic patient
16
Q
increased blood pressure to the kidneys resulting from atherosclerosis
A
renal hypertension
17
Q
a condition characterized by regions or areas of subcutaneous swelling caused by an allergic reaction to food or drugs is called what
A
angioedema
18
Q
the peripheral or outer portion of the kidney is called what
A
cortex
19
Q
what is the term that describes the total functioning portion of the kidney
A
renal parenchyma
20
Q
what category of systemic contrast media reaction results in tachycardia (>100 beats/min)
A
moderate
21
Q
these are located directly superior to the kidneys
A
suprarenal (adrenal) glands
22
Q
what category of systemic contrast media reaction results in angioedema
A
moderate
23
Q
act of voiding
A
micturition
24
Q
T/F - the glomerular capsule and proximal and distal convoluted tubules are located in the medulla of the kidney
A
false - cortex
25
what portion of the kidney is the collecting tubule in
medulla
26
what category of systemic contrast media reaction results in lightheadedness
mild
27
what category of systemic contrast media reaction results in hypotension (systolic blood pressure <80 mmHg
severe
28
contraction of the muscles within the walls of the bronchis and bronchioles, producing a restriction of air passing through them, is a condition called what
bronchospasm
29
what is the total capacity for the average adult bladder
350-500 mL
30
loss of consciousness resulting from reduced cerebral blood flow is called what
syncope
31
what are the two most common types of needles used for bolus injection of contrast media
- butterfly
- over-the-needle catheter
32
normal kidney that fails to ascend into the abdomen but remains in the pelvis
ectopic kidney
33
what category of systemic contrast media reaction results in laryngeal swelling
severe
34
rapid excretion of contrast media radiographically
renal hypertension
35
what category of systemic contrast media reaction results in cardiac arrest
severe
36
what category of systemic contrast media reaction results in mild hives
mild
37
T/F - mild level contrast media reactions do not usually require medication or medical assistance
true
38
what are the 6 steps followed during a venipuncture procedure
1. wash hands and put on gloves
2. select site, apply tourniquet, cleanse site
3. initiate puncture
4. confirm entry
5. prepare and proceed with injection
6. remove needle or catheter
39
T/F - urticaria is the formal term for excessive vomiting
false - hives
40
an eruption of wheals (hives), often caused by a hpyersensitivity to food or drugs is a condition called what
urticaria
41
what type of iodinated contrast media uses a parent compound of an amide or glucose group
nonionic
42
mucosal changes within bladder radiographic appearance
cystitis
43
what type of iodinated contrast media uses a parent compound of a benzoic acid
ionic
44
what compounds are a common anion found in ionic contrast media
diatrizoate or iothalamate
45
convulsions is a symptom of what type of contrast media reaction
severe systemic
46
an expected outcome to the introduction of contrast media is described as what
side effect
47
metallic taste is a symptom of what type of contrast media reaction
side effect
48
angioedema is a symptom of what type of contrast media reaction
moderate systemic
49
bradycardia is a symptom of what type of contrast media reaction
severe systemic
50
itching is symptom of what type of contrast media reaction
mild systemic
51
T/F - the patient should void before an IVU to prevent possible rupture of the bladder if compression is applied
true
52
signs of obstruction of urinary bladder radiographic appearance
renal calculi
53
what are the 5 step imaging sequence for a routine IVU
- 1 min nephrogram or nephrotomogram
- 5 min full KUB
- 10-15 min full KUB
- 20 min L + R PO
- postvoid (prone PA or erect AP)
54
what drug is often given to the patient as part of the premedication procedure
combination of Benadryl and prednisone
55
temporary hot flash is a symptom of which type of contrast media reaction
side effect
56
what are the two general categories of contrast media reactions
- local
- systemic
57
respiratory arrest is a symptom of what type of contrast media reaction
severe systemic
58
pulmonary edema is a symptom of which type of contrast media reaction
severe systemic
59
severe urticaria is a symptom of which type of contrast media reaction
moderate systemic
60
what is the primary purpose of ureteric compression
to enhance filling of the renal pelvic calyceal system and proximal ureters with contrast media
61
what should the tech do first when a patient is experiencing either a moderate or severe level contrast media reaction
call for medical assistance
62
when does the timing for an IVU exam start
at the start of the injection of contrast media
63
what is the primary purpose of the premedication procedure before an iodinated contrast media procedure
to reduce the severity of contrast media reactions
64
T/F - acute renal failure may occur 48 hours after an iodinated contrast media procedure
true
65
a trademark name for a diuretic drug is what
lasix
66
what type of reaction is a true allergic response to iodinated contrast media
anaphylactic reaction
67
what is IVU (intravenous urogram) an exam of
kidneys, ureters and bladder
68
in which department are most retrograde urograms performed
surgery (inpatient or outpatient facility)
69
which structures create a 20 degree angle between upper and lower poles of the kidney
psoas major muscles
70
what degree of rotation from supine is required to place the kidneys parallel to the IR
30 degrees
71
extravasation is a symptom of what type of contrast media reaction
local
72
T/F - the Brodney clamp is used for male and female retrograde cystourethrograms
false - males only
73
what type of iodinated contrast media will not significantly increase the osmolarity of the blood plasma
nonionic
74
what type of iodinated contrast media incorporates sodium or maglumine to increase solubility of the contrast media
ionic
75
in addition to notifying a nurse or physician when contrast media has extravasated into the soft tissue, what should the tech first do to increase absorption
elevate the affected extremity or use a cold compress followed by a warm compress
76
T/F - tissue inflammation from extravasated contrast media peaks 1-2 hours after the incident
false - 24-48 hours
77
which two landmarks can be palpated to locate the kidneys
xiphoid process and iliac crest
78
what are 10 contraindications that may prevent a patient from having a contrast media procedure performed
- hypersensitivity to iodinated contrast
- anuria
- multiple myeloma
- diabetes mellitus
- severe hepatic or renal disease
- congestive heart failure
- pheochromocytoma
- sickle cell anemia
- patients taking metformin or similar med
- renal failure, acute or chronic
79
what term describes an abnormal drop of the kidneys when the patient is placed erect
nephroptosis
80
what are the 3 functions of the urinary system
- remove nitrogenous waste
- regulate water levels
- regulate acid-base balance and electrolyte levels in the blood
81
a buildup of nitrogenous waste in the blood is called what
uremia
82
what is the microscopic functional and structural unit of the kidney
nephron
83
T/F - the efferent arterioles carry blood to the glomeruli
false - afferent arterioles
84
what is another (older) term for the glomerular capsule
Bowman capsule
85
which structure of the medulla is made up of a collection of tubules that drain into the minor calyx
renal pyramids
86
what portion of the kidney is the loop of Henle in
medulla
87
what portion of the kidney is the distal convoluted tubule in
cortex
88
what is IVP (intravenous pyelogram) a study of
renal pelvis
89
which involves a direct introduction of contrast media into the structure being studied
- retrograde urogram
- retrograde cystogram
- retrograde urethrogram
- all of the above
all of the above
90
irregular appearance of renal parenchyma or collecting system radiographic appearance
renal cell carcinoma
91
what specific aspect of the kidney is visualized during an IVU
collecting system (major and minor calyces, renal pelvis, proximal ureters)
92
what condition is a common pathologic indication for an IVU
hematuria
93
what condition is described as a rare tumor of the adrenal gland
pheochromocystoma
94
inability to void
retention
95
what alternate imaging modality is not routinely used to diagnose renal calculi
MRI
96
what portion of the kidney is the afferent arteriole in
cortex
97
what portion of the kidney is the efferent arteriole in
cortex
98
diminished amount of urine being excreted
oliguria
99
indicated by the presence of uremia, oliguria, or anuria
acute renal failure
100
what portion of the kidney is the glomerular capsule in
cortex
101
constant or frequent involuntary passage of urine
urinary incontinence
102
absence of a functioning kidney
renal agenisis
103
T/F - urinary studies on pediatric patients should be scheduled early in the morning to minimize the risk for dehydration
true
104
complete cessation of urinary secretions
anuria
105
enlargement of the prostate gland
benign prostatic hyperplasia (BPH)
106
multiple cysts in one or both kidneys
polycystic kidney disease
107
signs of abnormal fluid collections radiographic appearance
vesicorectal fistula
108
abnormal rotation of the kidney radiographic appearance
malrotation
109
what portion of the kidney is the proximal convoluted tubule in
cortex
110
what portion of the kidney is the descending limb in
medulla
111
elevated or indented floor of bladder radiographic appearance
benign prostatic hyperplasia (BPH)
112
what type of renal calculi is often associated with chronic urinary tract infections
staghorn calculi
113
what portion of the kidney is the ascending limb in
medulla
114
what are the 6 conditions that could contraindicate the use of ureteric compression
1. possible ureteric stones
2. abdominal mass
3. abdominal aortic aneurysm
4. recent abdominal surgery
5. severe abdominal pain
6. acute abdominal trauma
115
which two processes move urine through the ureters to the bladder
- peristalsis
- gravity
116
what is the primary difference between a standard and a hypertensive IVU
hypertensive IVU requires a shorter time span between images
117
what structure is located most anterior
- proximal ureters
- kidneys
- urinary bladder
- suprarenal glands
urinary bladder
118
T/F - a retrograde urogram examines the anatomy and function of the pelvicalyceal system
false - nonfunctional study
119
what is the name of the inner, posterior region of the bladder formed by the two ureters entering and the urethra exiting
trigone
120
what is the name of the small gland found just inferior to the male bladder
prostate gland
121
which of the following structures is considered most posterior
- ovaries
- urethra
- vagina
- kidneys
kidneys
122
how can intravenous contrast media be administered by
- bolus
- drip infusion
123
exposure factors used during a CT procedure can be adjusted to compensate for a decrease or increase in body size according to what
height and weight
124
T/F - a patient does not require extensive bowel preparation before a CT scan for renal calculi
true
125
T/F - nuclear medicine is highly effective in demonstrating signs of vesicoureteral reflux
true
126
T/F - the parent (or legal guardian) must sign an informed consent form before a venipuncture procedure is performed on a pediatric patient
true
127
where should the pneumatic paddle be placed for the ureteric compression phase of an IVU
just medial to ASIS and lateral to spine (over the outer pelvic brim)
128
for most IVUs veins located where are recommended for venipuncture
antecubital fossa
129
what can be done to enhance filling of the calyces of the kidney if ureteric compression is contraindicated
place patient in a 15 degree Trendelenburg position
130
what are the 4 reasons a scout projection is taken before the injection of contrast media for an IVU
- verify patient prep
- determine whether exposure factors are acceptable
- verify positioning
- detect any abnormal calcifications
131
passage of a large volume of urine
polyuria
132
what is the most common size of needle used for bolus injections on adults
18-22 gauge
133
presence of glucose in urine
glucosuria
134
excess urea and creatinine in the blood
uremia
135
what type of iodinated contrast media creates a hypertonic condition in the blood plasma
ionic
136
what type of iodinated contrast media is more expensive
nonionic
137
T/F - the bevel of the needle must face downward during the actual puncture into a vein
false - forward
138
presence of gas in urine
pneumouria
139
what is the specific name for the mass of fat that surrounds each kidney
perirenal fat or adipose capsule
140
what type of iodinated contrast media produces less severe reactions
nonionic
141
backward return flow of urine
urinary reflux
142
fusion of the lower poles of kidneys during the development of the fetus
horseshoe kidney
143
what type of iodinated contrast media is a near-isotonic solution
nonionic
144
T/F - if extravasation occurs during the puncture, the tech should slightly retract the needle and then push it forward again
false - needle should be withdrawn and pressure applied
145
which specific position is recommended for a male patient during a voiding cystourethrogram
30 degree RPO
146
T/F - if unsuccessful during the initial puncture a new needle should be used during the second attempt
true
147
T/F - the radiologist is responsible for documenting all aspects of the venipuncture procedure in the patient's chart
false - tech or person performing the venipuncture
148
what kVp range is recommended for an IVU
80-85
149
what type of iodinated contrast media poses a greater risk for disrupting homeostasis
ionic
150
T/F - the number of retrograde urography procedures for urethral calculi has been reduced as a result of the increased use of CT
true
151
which imaging modality is used to detect subtle tissue changes following a renal transplant
MRI
152
how will an enlarged prostate gland appear on a postvoid radiograph taken during an IVU
prostate gland will indent the floor of the bladder
153
what type of iodinated contrast media may increase the severity of side effects
ionic
154
a retrograde pyelogram is primarily a nonfunctional study of what
renal pelvis - major and minor calyces of the kidney
155
what specific anatomy is examined during a retrograde ureterogram
primarily the ureters
156
T/F - there is a change in SID recommendations when placing a patient erect v. supine for an IVU AP projection
false
157
what is the normal creatinine level range for an adult
0.6-1.5 mg/dL
158
T/F - male and female patients should have the gonads shielded for an AP scout projection
false - not female
159
what is the normal blood urea nitrogen (BUN) level range for an adult
8-25 mg/100mL
160
T/F - nephrotomograms produced during an IVU most commonly use an exposure angle of < or equal to 10 degrees
true
161
metformin hydrochloride is a drug that is taken for the management of what
diabetes mellitus
162
how many tomograms (or focal levels) are usually produced during a routine IVU
3 tomograms or focal levels
163
the ACR recommends that metformin be withheld for how many 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, resumed only if kidney function is again determine to be within normal limits
48 hours
164
the longitudinal fissure found along the central medial border of the kidney is called what
hilum
165
what is the name of the junction found between the distal ureters and the urinary bladder
ureterovesical junction (UVJ)
166
inflammation of the capillary loops of the glomeruli of the kidneys
glomerulonephritis
167
the leakage of contrast media from a vessel into the surrounding soft tissues is called what
extravasation (infiltration)
168
artificial opening between the urinary bladder and aspects of the large intestine
vesicorectal fistula
169
vomiting is a symptom of which type of contrast media reaction
mild systemic
170
bilateral small kidneys with blunted calyces radiographic appearance
chronic bright disease
