Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Patient Management 2 > Contrast Administration and Venipuncture > Flashcards

Contrast Administration and Venipuncture Flashcards

1
Q

Why are contrast agent categorized as drugs?

A
  • they can be absorbed into systemic circulation
  • they may produce a physiologic response in the body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Positive Contrast Agents

A
  • Adds density.
  • Appears white or light (radiopaque)
  • Positive agent are effective photon absorbers.
  • Ex. Barium sulfate, Gastrografin, Iodinated intravenous contrast media.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Barium Sulfate (BaSO4)

A

Z of Ba = 56
Inert compound
Does not dissolve; suspended in solution
Commonly use in imaging of GI system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is flocculation?

A

Stomach acid can cause clumping of Barium Sulfate causing it to come out of solution
- Sodium carbonate and sodium citrate can be added as stabilizing agents to prevent flocculation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Barium Enema

A
  1. enema tip
  2. enema tube
  3. enema recevoir bag
  4. balloon with inflator
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Barium sulfate Precautions and Complications

A
  • Barium sulfate contrast media is contraindicated if perforation of the digestive tract is suspected.
  • Barium sulfate is not absorbed by the body. Therefore, if it enters the peritoneal cavity it would require to be surgically removed. If not removed, it can result in barium peritonitis which is highly fatal.
  • A water-soluble iodinated contrast is recommended when a GI perforation is suspected as it is capable of being absorbed by the body.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Barium sulfate Precautions and Complications in Women

A
  • Vaginal rupture is a rare complication caused due to incorrect placement of the enema tube/catheter.
  • Barium may also enter the peritoneal cavity upon exiting the uterus via the fallopian tubes. Therefore, female patients should be asked whether they can feel the enema tip in the rectum prior to administration of the suspension.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Water Soluble Iodinated Contrast Media

A
  • Intravascular radiopaque contrast media are primarily used to add density to vasculature.
  • Osmolality is a measure of the total number of particles in solution per kilogram of solvent.
  • Unit of solute concentration.
  • Osmolality of a solution determines osmotic pressure, which controls the movement of water in the body.
  • Tend to have high viscosity; Influenced by concentration of the molecule.
  • Viscosity affects the injectability of the medium.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Water Soluble Iodinated Contrast Media Temperature

A
  • Heating the medium to body temperature significantly reduces viscosity and facilitates rapid injection.
  • Heating is commonly achieved through a contrast warmer.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Reactions to Intravenous Contrast Media

A

Expected side effects must be explained to the patient prior to contrast administration:
- Feeling of warmth and flushing
- Metallic taste in mouth
- Nausea and/or vomiting
- Headache
- Sensation of urination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Allergic Effects of Intravenous Contrast Media (Mild)

A

Urticaria
- Premedication with steroids and antihistamine is indicated if patient has a hx.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Allergic Effects of Intravenous Contrast Media (Severe)

A

Dyspnea related to laryngeal edema, Seizure, Cardiac arrest
- Rare and not predictable
- Hx of severe reaction is contraindicated to IV contrast media administration.
- Non-contrast exam or alternate modality may be considered by radiologist.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Allergic Effects of Intravenous Contrast Media (Moderate)

A

Tachycardia/Bradycardia, Hypertension/Hypotension, Dyspnea, Bronchospasm/wheezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Vasovagal response to intravenous contrast media

A
  • Reaction to the procedure itself.
  • Patient may be experiencing high anxiety concerning the procedures and/or results.
  • Invasive radiographic procedures are frequently stressful.
  • Can affect the outcome of the exam. Therefore, radiographer must be able to identify highly anxious patients during the initial assessment interview.
  • Therapeutic communication techniques must be used to alleviate patient anxiety.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical Manifestations of Vasovagal reaction

A
  • Pallor (pale skin)
  • Cold sweats
  • Rapid pulse
  • Syncope or complaint of feeling faint
  • Bradycardia
  • Hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Renal Effects of Contrast Media

A

Contrast Induced Nephropathy (CIN)
- It is generally a transient and reversible form of acute renal failure.
- However, the development of CIN is associated with a longer hospital stay, an increased morbidity and mortality, in addition to a higher financial cost.

17
Q

Estimated glomerular filtration rate values

A

<30 ml/min = NO CONTRAST
30 < eGFR < 40 = Contrast with hydration; risks explained to patient by radiologist; written consent obtained.
>40 ml/min = CONTRAST
- N-acetylcysteine: Can prevent impairment of kidney function. May be used in patients with high risk of renal failure if contrast is essential for scan.
- Dialysis is an exemption to administering intravenous IV contrast media when the patient fails eGFR screening; Ideally, must be performed soon (within 24 hours) post contrast injection.

18
Q

Drug interactions with intravenous contrast media: Metformin (Glucophage)

A
  • Used to treat non-insulin dependent diabetes.
  • Metformin causes increase glucose uptake by cells.
  • Metformin does not react with iodinated contrast agents.
  • By-product of glucose metabolism is lactic acid, which can accumulate in the system in the event of impaired renal function.
    Results in decrease in blood pH resulting in a lethal condition called lactic acidosis.
    Ideally, metformin should be discontinued 48 hours prior to and post iodinated contrast media injection.
19
Q

Negative Contrast Agents

A
  • Low atomic number elements
  • Appears radiolucent
  • Often used with positive contrast agents.
  • E.g., Air/Carbon dioxide/Gas (or gas producing granules)
20
Q

Parenteral Drug Administration

A
  • Most parenteral administration involves penetrating the protective layers of the skin.
  • This requires following strict aseptic techniques and standard precautions should be followed when preparing and administering the drug.
21
Q

What types of syringes are used to administer parenteral drugs

A
  • Standard hypodermic syringe
  • Insulin syringe
  • Tuberculin syringe
  • Prefilled syringe
22
Q

Syringes

A
  • Syringes are plastic; disposed after one use.
  • Syringes may be packaged separately from the needle or together with the needle.
  • Syringes can be prefilled or empty.
23
Q

Parts of a syringe

A

Tip: where the needle attaches
Barrel: where the calibration scales(ml) are printed and the part that holds the drug
Plunger: The part that fits inside the barrel and changes the pressure inside the barrel as it is pulled in or out
- Ranges in size: 2, 2.5, 3, 5, 10, 20 & 50ml.

24
Q

Needle

A

Stainless steel
Disposable
3 parts:
1. Hub: part that attaches to the syringe
2. Cannula/Shaft: length of the metal part
3. Bevel: slanted part at the tip of the needle

25
Q

Needle Size

A

Needles are sized according to length and gauge.
- The gauge (G) refers to the thickness or diameter of the needle.
- The length refers to the measurement in inches of the shaft portion.

26
Q
A
27
Q

Needle use based on size

A
  • Shorter needles are used for subcutaneous injections while longer needles are used for intramuscular injections.
  • The smaller the diameter of the shaft, or the finer the needle, the larger the gauge number will be.
  • The viscosity of the fluid and speed of injection determine the gauge size used.
28
Q

Luer-Lock Syringe

A

Locking device at tip of syringe that holds the needle firmly in place.

29
Q

Typical IV Gauge Sizes and Power Injection Flow Rate

A

22G : up to 3cc/s
20G: 3 – 4cc/s
18: 5cc/s and up

30
Q

IVs in the Elderly

A
  • Veins are more fragile; also tend to roll as the needle is inserted.
  • Smaller needle may need to be used, but needle gauge size is limited by the rate of injection for the imaging procedure.
  • Tourniquet is more likely to damage the skin and must be applied with less tension.
  • Contrast agent is more likely to dehydrate an elderly patient.
31
Q

Extravasation of Intravenous Contrast Media

A
  • Complication of contrast enhanced imaging studies
  • Most extravasations involve small volumes of contrast material and induce minimal swelling and localized erythema (redness) , which rapidly diminishes.
32
Q

Extravasation of Intravenous Contrast Media

A
  • Extravasation of LOCM is better tolerated than that which occurs with HOCM.
  • If extravasation occurs, the first step is to remove the needle and apply pressure to the site.
  • Treatment includes elevation to reduce edema, a warm compress to produce vasodilation and resorption of extravasated fluid and edema.
  • A cold compress produces vasoconstriction and limits inflammation.
33
Q

Complications of Contrast Media Extravasation

A

Skin ulceration
Soft-tissue necrosis
Compartment syndrome

Patient Management 2 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions