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Positioning 1 > Ch. 14 Urinary System and Venipuncture Workbook > Flashcards

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

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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

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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

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4
Q

a large stone that grows and completely fills the renal pelvis

A

staghorn calculus

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5
Q

how much obliquity is required for the left/right posterior oblique projections taken during an IVU

A

30 degrees

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6
Q

which position best demonstrates possible nephroptosis

A

erect position

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7
Q

where are the kidneys and ureters located in relation to the peritoneum

A

retroperitoneal

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8
Q

at what stage of an IVU is the renal parenchyma best seen

A

within 1 minute after injection

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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

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10
Q

T/F - vasovagal reactions are not considered to be life threatening

A

false

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11
Q

where is the CR centered for a nephrotomogram

A

midway between xiphoid and iliac crest

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12
Q

what category of systemic contrast media reaction results in temporary renal failure

A

severe

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13
Q

what category of systemic contrast media reaction results in bradycardia (<50 beats/min)

A

severe

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14
Q

what CR angle is used for the AP projection taken during cystogram

A

10-15 degrees caudad

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15
Q

what type of patient is a likely candidate for the premedication procedure before a contrast media study

A

asthmatic patient

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16
Q

increased blood pressure to the kidneys resulting from atherosclerosis

A

renal hypertension

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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

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18
Q

the peripheral or outer portion of the kidney is called what

A

cortex

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19
Q

what is the term that describes the total functioning portion of the kidney

A

renal parenchyma

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20
Q

what category of systemic contrast media reaction results in tachycardia (>100 beats/min)

A

moderate

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21
Q

these are located directly superior to the kidneys

A

suprarenal (adrenal) glands

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22
Q

what category of systemic contrast media reaction results in angioedema

A

moderate

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23
Q

act of voiding

A

micturition

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24
Q

T/F - the glomerular capsule and proximal and distal convoluted tubules are located in the medulla of the kidney

A

false - cortex

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25
Q

what portion of the kidney is the collecting tubule in

A

medulla

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26
Q

what category of systemic contrast media reaction results in lightheadedness

A

mild

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27
Q

what category of systemic contrast media reaction results in hypotension (systolic blood pressure <80 mmHg

A

severe

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28
Q

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

A

bronchospasm

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29
Q

what is the total capacity for the average adult bladder

A

350-500 mL

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30
Q

loss of consciousness resulting from reduced cerebral blood flow is called what

A

syncope

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31
Q

what are the two most common types of needles used for bolus injection of contrast media

A
  • butterfly
  • over-the-needle catheter
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32
Q

normal kidney that fails to ascend into the abdomen but remains in the pelvis

A

ectopic kidney

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33
Q

what category of systemic contrast media reaction results in laryngeal swelling

A

severe

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34
Q

rapid excretion of contrast media radiographically

A

renal hypertension

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35
Q

what category of systemic contrast media reaction results in cardiac arrest

A

severe

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36
Q

what category of systemic contrast media reaction results in mild hives

A

mild

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37
Q

T/F - mild level contrast media reactions do not usually require medication or medical assistance

A

true

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38
Q

what are the 6 steps followed during a venipuncture procedure

A
  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
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39
Q

T/F - urticaria is the formal term for excessive vomiting

A

false - hives

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40
Q

an eruption of wheals (hives), often caused by a hpyersensitivity to food or drugs is a condition called what

A

urticaria

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41
Q

what type of iodinated contrast media uses a parent compound of an amide or glucose group

A

nonionic

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42
Q

mucosal changes within bladder radiographic appearance

A

cystitis

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43
Q

what type of iodinated contrast media uses a parent compound of a benzoic acid

A

ionic

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44
Q

what compounds are a common anion found in ionic contrast media

A

diatrizoate or iothalamate

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45
Q

convulsions is a symptom of what type of contrast media reaction

A

severe systemic

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46
Q

an expected outcome to the introduction of contrast media is described as what

A

side effect

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47
Q

metallic taste is a symptom of what type of contrast media reaction

A

side effect

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48
Q

angioedema is a symptom of what type of contrast media reaction

A

moderate systemic

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49
Q

bradycardia is a symptom of what type of contrast media reaction

A

severe systemic

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50
Q

itching is symptom of what type of contrast media reaction

A

mild systemic

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51
Q

T/F - the patient should void before an IVU to prevent possible rupture of the bladder if compression is applied

A

true

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52
Q

signs of obstruction of urinary bladder radiographic appearance

A

renal calculi

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53
Q

what are the 5 step imaging sequence for a routine IVU

A
  • 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)
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54
Q

what drug is often given to the patient as part of the premedication procedure

A

combination of Benadryl and prednisone

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55
Q

temporary hot flash is a symptom of which type of contrast media reaction

A

side effect

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56
Q

what are the two general categories of contrast media reactions

A
  • local
  • systemic
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57
Q

respiratory arrest is a symptom of what type of contrast media reaction

A

severe systemic

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58
Q

pulmonary edema is a symptom of which type of contrast media reaction

A

severe systemic

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59
Q

severe urticaria is a symptom of which type of contrast media reaction

A

moderate systemic

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60
Q

what is the primary purpose of ureteric compression

A

to enhance filling of the renal pelvic calyceal system and proximal ureters with contrast media

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61
Q

what should the tech do first when a patient is experiencing either a moderate or severe level contrast media reaction

A

call for medical assistance

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62
Q

when does the timing for an IVU exam start

A

at the start of the injection of contrast media

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63
Q

what is the primary purpose of the premedication procedure before an iodinated contrast media procedure

A

to reduce the severity of contrast media reactions

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64
Q

T/F - acute renal failure may occur 48 hours after an iodinated contrast media procedure

A

true

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65
Q

a trademark name for a diuretic drug is what

A

lasix

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66
Q

what type of reaction is a true allergic response to iodinated contrast media

A

anaphylactic reaction

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67
Q

what is IVU (intravenous urogram) an exam of

A

kidneys, ureters and bladder

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68
Q

in which department are most retrograde urograms performed

A

surgery (inpatient or outpatient facility)

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69
Q

which structures create a 20 degree angle between upper and lower poles of the kidney

A

psoas major muscles

70
Q

what degree of rotation from supine is required to place the kidneys parallel to the IR

A

30 degrees

71
Q

extravasation is a symptom of what type of contrast media reaction

A

local

72
Q

T/F - the Brodney clamp is used for male and female retrograde cystourethrograms

A

false - males only

73
Q

what type of iodinated contrast media will not significantly increase the osmolarity of the blood plasma

A

nonionic

74
Q

what type of iodinated contrast media incorporates sodium or maglumine to increase solubility of the contrast media

A

ionic

75
Q

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

A

elevate the affected extremity or use a cold compress followed by a warm compress

76
Q

T/F - tissue inflammation from extravasated contrast media peaks 1-2 hours after the incident

A

false - 24-48 hours

77
Q

which two landmarks can be palpated to locate the kidneys

A

xiphoid process and iliac crest

78
Q

what are 10 contraindications that may prevent a patient from having a contrast media procedure performed

A
  • 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
Q

what term describes an abnormal drop of the kidneys when the patient is placed erect

A

nephroptosis

80
Q

what are the 3 functions of the urinary system

A
  • remove nitrogenous waste
  • regulate water levels
  • regulate acid-base balance and electrolyte levels in the blood
81
Q

a buildup of nitrogenous waste in the blood is called what

A

uremia

82
Q

what is the microscopic functional and structural unit of the kidney

A

nephron

83
Q

T/F - the efferent arterioles carry blood to the glomeruli

A

false - afferent arterioles

84
Q

what is another (older) term for the glomerular capsule

A

Bowman capsule

85
Q

which structure of the medulla is made up of a collection of tubules that drain into the minor calyx

A

renal pyramids

86
Q

what portion of the kidney is the loop of Henle in

A

medulla

87
Q

what portion of the kidney is the distal convoluted tubule in

A

cortex

88
Q

what is IVP (intravenous pyelogram) a study of

A

renal pelvis

89
Q

which involves a direct introduction of contrast media into the structure being studied
- retrograde urogram
- retrograde cystogram
- retrograde urethrogram
- all of the above

A

all of the above

90
Q

irregular appearance of renal parenchyma or collecting system radiographic appearance

A

renal cell carcinoma

91
Q

what specific aspect of the kidney is visualized during an IVU

A

collecting system (major and minor calyces, renal pelvis, proximal ureters)

92
Q

what condition is a common pathologic indication for an IVU

A

hematuria

93
Q

what condition is described as a rare tumor of the adrenal gland

A

pheochromocystoma

94
Q

inability to void

A

retention

95
Q

what alternate imaging modality is not routinely used to diagnose renal calculi

A

MRI

96
Q

what portion of the kidney is the afferent arteriole in

A

cortex

97
Q

what portion of the kidney is the efferent arteriole in

A

cortex

98
Q

diminished amount of urine being excreted

A

oliguria

99
Q

indicated by the presence of uremia, oliguria, or anuria

A

acute renal failure

100
Q

what portion of the kidney is the glomerular capsule in

A

cortex

101
Q

constant or frequent involuntary passage of urine

A

urinary incontinence

102
Q

absence of a functioning kidney

A

renal agenisis

103
Q

T/F - urinary studies on pediatric patients should be scheduled early in the morning to minimize the risk for dehydration

A

true

104
Q

complete cessation of urinary secretions

A

anuria

105
Q

enlargement of the prostate gland

A

benign prostatic hyperplasia (BPH)

106
Q

multiple cysts in one or both kidneys

A

polycystic kidney disease

107
Q

signs of abnormal fluid collections radiographic appearance

A

vesicorectal fistula

108
Q

abnormal rotation of the kidney radiographic appearance

A

malrotation

109
Q

what portion of the kidney is the proximal convoluted tubule in

A

cortex

110
Q

what portion of the kidney is the descending limb in

A

medulla

111
Q

elevated or indented floor of bladder radiographic appearance

A

benign prostatic hyperplasia (BPH)

112
Q

what type of renal calculi is often associated with chronic urinary tract infections

A

staghorn calculi

113
Q

what portion of the kidney is the ascending limb in

A

medulla

114
Q

what are the 6 conditions that could contraindicate the use of ureteric compression

A
  1. possible ureteric stones
  2. abdominal mass
  3. abdominal aortic aneurysm
  4. recent abdominal surgery
  5. severe abdominal pain
  6. acute abdominal trauma
115
Q

which two processes move urine through the ureters to the bladder

A
  • peristalsis
  • gravity
116
Q

what is the primary difference between a standard and a hypertensive IVU

A

hypertensive IVU requires a shorter time span between images

117
Q

what structure is located most anterior
- proximal ureters
- kidneys
- urinary bladder
- suprarenal glands

A

urinary bladder

118
Q

T/F - a retrograde urogram examines the anatomy and function of the pelvicalyceal system

A

false - nonfunctional study

119
Q

what is the name of the inner, posterior region of the bladder formed by the two ureters entering and the urethra exiting

A

trigone

120
Q

what is the name of the small gland found just inferior to the male bladder

A

prostate gland

121
Q

which of the following structures is considered most posterior
- ovaries
- urethra
- vagina
- kidneys

A

kidneys

122
Q

how can intravenous contrast media be administered by

A
  • bolus
  • drip infusion
123
Q

exposure factors used during a CT procedure can be adjusted to compensate for a decrease or increase in body size according to what

A

height and weight

124
Q

T/F - a patient does not require extensive bowel preparation before a CT scan for renal calculi

A

true

125
Q

T/F - nuclear medicine is highly effective in demonstrating signs of vesicoureteral reflux

A

true

126
Q

T/F - the parent (or legal guardian) must sign an informed consent form before a venipuncture procedure is performed on a pediatric patient

A

true

127
Q

where should the pneumatic paddle be placed for the ureteric compression phase of an IVU

A

just medial to ASIS and lateral to spine (over the outer pelvic brim)

128
Q

for most IVUs veins located where are recommended for venipuncture

A

antecubital fossa

129
Q

what can be done to enhance filling of the calyces of the kidney if ureteric compression is contraindicated

A

place patient in a 15 degree Trendelenburg position

130
Q

what are the 4 reasons a scout projection is taken before the injection of contrast media for an IVU

A
  • verify patient prep
  • determine whether exposure factors are acceptable
  • verify positioning
  • detect any abnormal calcifications
131
Q

passage of a large volume of urine

A

polyuria

132
Q

what is the most common size of needle used for bolus injections on adults

A

18-22 gauge

133
Q

presence of glucose in urine

A

glucosuria

134
Q

excess urea and creatinine in the blood

A

uremia

135
Q

what type of iodinated contrast media creates a hypertonic condition in the blood plasma

A

ionic

136
Q

what type of iodinated contrast media is more expensive

A

nonionic

137
Q

T/F - the bevel of the needle must face downward during the actual puncture into a vein

A

false - forward

138
Q

presence of gas in urine

A

pneumouria

139
Q

what is the specific name for the mass of fat that surrounds each kidney

A

perirenal fat or adipose capsule

140
Q

what type of iodinated contrast media produces less severe reactions

A

nonionic

141
Q

backward return flow of urine

A

urinary reflux

142
Q

fusion of the lower poles of kidneys during the development of the fetus

A

horseshoe kidney

143
Q

what type of iodinated contrast media is a near-isotonic solution

A

nonionic

144
Q

T/F - if extravasation occurs during the puncture, the tech should slightly retract the needle and then push it forward again

A

false - needle should be withdrawn and pressure applied

145
Q

which specific position is recommended for a male patient during a voiding cystourethrogram

A

30 degree RPO

146
Q

T/F - if unsuccessful during the initial puncture a new needle should be used during the second attempt

A

true

147
Q

T/F - the radiologist is responsible for documenting all aspects of the venipuncture procedure in the patient’s chart

A

false - tech or person performing the venipuncture

148
Q

what kVp range is recommended for an IVU

A

80-85

149
Q

what type of iodinated contrast media poses a greater risk for disrupting homeostasis

A

ionic

150
Q

T/F - the number of retrograde urography procedures for urethral calculi has been reduced as a result of the increased use of CT

A

true

151
Q

which imaging modality is used to detect subtle tissue changes following a renal transplant

A

MRI

152
Q

how will an enlarged prostate gland appear on a postvoid radiograph taken during an IVU

A

prostate gland will indent the floor of the bladder

153
Q

what type of iodinated contrast media may increase the severity of side effects

A

ionic

154
Q

a retrograde pyelogram is primarily a nonfunctional study of what

A

renal pelvis - major and minor calyces of the kidney

155
Q

what specific anatomy is examined during a retrograde ureterogram

A

primarily the ureters

156
Q

T/F - there is a change in SID recommendations when placing a patient erect v. supine for an IVU AP projection

A

false

157
Q

what is the normal creatinine level range for an adult

A

0.6-1.5 mg/dL

158
Q

T/F - male and female patients should have the gonads shielded for an AP scout projection

A

false - not female

159
Q

what is the normal blood urea nitrogen (BUN) level range for an adult

A

8-25 mg/100mL

160
Q

T/F - nephrotomograms produced during an IVU most commonly use an exposure angle of < or equal to 10 degrees

A

true

161
Q

metformin hydrochloride is a drug that is taken for the management of what

A

diabetes mellitus

162
Q

how many tomograms (or focal levels) are usually produced during a routine IVU

A

3 tomograms or focal levels

163
Q

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

A

48 hours

164
Q

the longitudinal fissure found along the central medial border of the kidney is called what

A

hilum

165
Q

what is the name of the junction found between the distal ureters and the urinary bladder

A

ureterovesical junction (UVJ)

166
Q

inflammation of the capillary loops of the glomeruli of the kidneys

A

glomerulonephritis

167
Q

the leakage of contrast media from a vessel into the surrounding soft tissues is called what

A

extravasation (infiltration)

168
Q

artificial opening between the urinary bladder and aspects of the large intestine

A

vesicorectal fistula

169
Q

vomiting is a symptom of which type of contrast media reaction

A

mild systemic

170
Q

bilateral small kidneys with blunted calyces radiographic appearance

A

chronic bright disease

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