Contrast Administration (27/28)

Question 1

3 major known SE of Iodine Contrast

Answer 1

N/V
Nephrotoxicity
Sensation of urination

Question 2

Iodine Contrast: Pt Prep (3)

Answer 2

Prehydration x 24hr to help kidneys
NPO 1hr to decrease N/V
Posthydration to help minimize nephrotoxicity

Question 3

Renal Function Eval

Answer 3

Labs used for Pts w risk factors for compromised renal function

Question 4

BUN

Answer 4

“Blood Urea Nitrogen”
Amount of Nitrogen in blood in form of urea

Question 5

Urea (2)

Answer 5

Byproduct of protein metabolism in liver
Collected/excreted by kidneys

Question 6

BUN Normals

Answer 6

7-21 mg/dL
>50 may indicate renal failure

Question 7

Creatinine (3)

Answer 7

Chemical byproduct of muscular metabolism
Produced at fairly constant rate
Collected/Excreted by kidneys

Question 8

Creatinine Normals

Answer 8

0.7-1.5 mg/dL

Question 9

Factors affecting creatinine levels (4)

Answer 9

Age
Gender
Muscle mass
Hydration

Question 10

GFR
Estimates…
Calculated from…

Answer 10

“Glomerular Filtration Rate”
…rate at which glomeruli filter waste from blood
…creatinine/age/gender

Question 11

GFR Normals
(& level indicating renal failure)

Answer 11

90-120 ml/min/1.73m^2
<30 may indicate renal failure

Question 12

Premedication for Iodine Contrast:
Given for…
2 categories:

Answer 12

…known iodine allergy:
Corticoseroids (prednisone)
Anti-histamines (diphenhydramine)

Question 13

Iodine Contrast Premedication: Coricosteroids
Example (2)
Dose
Timing

Answer 13

Prednisone 50mg/methyprednisolone (Solu-Medrol)
At least 12h prior and 1h post

Question 14

Iodine Contrast Premedication: Anti-histamines
Example: Name/Dose/Route/Timing

Answer 14

E.g., diphenhydramine 50mg admin’d IV, IM, oral 1h prior

Question 15

Access points unacceptable for contrast injection

Answer 15

Jugular (extrav in neck too risky)
Dialysis Caths

Question 16

IV gauge tolerance rates

Answer 16

22 up to 5mL/sec
20 preferred for 3+ mL/sec
*for more peripheral site reduce to 1-2mL/sec

Question 17

Venipuncture Documentation Req’s (4)

Answer 17

Site
Size
Date
No of attempts

Question 18

Contrast Documentation Req’s (4)

Answer 18

Label: Brand/Concentration/Lot#/Exp Date
Concentration
Volume
Injection Rate

Question 19

Metoclopramide

Answer 19

Reglan

Question 20

Creatinin of >2.0 mg/dL may indicate

Answer 20

renal failure for most Pts

Question 21

Lower levels of creatinine may indicate

Answer 21

muscular problems

Question 22

Higher levels of creatinine may indicate

Answer 22

renal disease

Question 23

Calculation of GFR includes (3)

Answer 23

creatinine/age/gender

Question 24

BUN >50 may indicate

Answer 24

Renal failure

Question 25

Methyprednisolone

Answer 25

Solu-Medrol

Question 26

BUN >50 may indicate

Answer 26

Renal failure