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Pt Care 2 > Contrast and injections and who goes 1st > Flashcards

Contrast and injections and who goes 1st Flashcards

1
Q

master list of trade names of contrast

A

Reference List: Trade names of types of Contrast Media
• Omnipaque
• Optiray
• Visipaque
• Isovue
• Conray
• Cysto-conray
• Hypaque
• Hypaque-cysto
• Gastrografin
• Sinografin
• Barium sulfate

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2
Q

brands used for myelogram

A
  • Omnipaque
  • Isovue
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3
Q

brands used for retrograde urography

A
  • Hypague-Cysto
  • Cysto-Conray
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4
Q

brands used for 3. Endoscopic retrograde cholangiopancreatography (ERCP):

A
  • Conray
  • Hypaque
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5
Q

brands used for small bowel series

A
  • Barium Sulfate
  • Gastrografin
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6
Q

brand used for hysterosalpingogram

A

-sinographin

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7
Q

Arthrogram:

A
  • Conray
  • Visipaque
  • Hypaque
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8
Q

brands used for cerebral angiography

A
  • Optiray
  • Visipaque
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9
Q

brands used for 8. Computed tomography (oral administration):

A
  • Gastrografin
  • Hypaque
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10
Q

what 2 general ways can IV fluids or medications enter tissue around the vein?

A

Leak or accidental injection

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11
Q

how can leakage be caused?

A
  • vein rupturing
  • fluid passing through walls of intact vein b/c of high pressure injection (e.g. 5cc/sec)
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12
Q

What is another name often used for extravasation? How do the definitions differ?

A
  • infiltration
  • extravasation means fluid outside the vessel, infiltration means fluid has diffused into surrounding tissue
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13
Q

extravasation and infiltration are what 2 things? (both not great)

A

painful and/or dangerous

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14
Q

what does it mean when something is a “vesicant” agent?

A

causines or forms blisters

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15
Q

why is the selection of a patient’s iv site location so important? where do we not start an iv?

A
  • tissue erosion sucks
  • could potentially need skin grafts
  • avoid starting on anterior side of the wrist
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16
Q

What are some initial signs of extravasation?

A
  • the patient expressing discomfort and pain
  • possible swelling around iv site
17
Q

4 techniques to avoiding infiltration

A
  • Check for backflow of blood to be certain the catheter is properly situated before injecting.
  • Immobilize/secure the catheter correctly at the injection site (this reduces the possibility of the IV catheter snagging).
  • Stop the injection immediately if patient complains of discomfort at the injection site.
  • Power injectors used in Diagnostic Imaging (DI) department are programmed to give a “test run” of saline first. During the test run, the tech can “feel” the saline being injected and there is a monitor that shows the amount of pressure and resistance occurring in the vein.
18
Q

Treatment of Infiltration: so many things

A
  • Remove needle and treat prior to attempting to start another IV.
  • Inform patient that the pain felt is temporary.
  • Maintain pressure on the vein until bleeding has stopped (patients on blood thinners will need pressure applied for at least 5 minutes). This reduces the chance of a hematoma forming.
  • Apply cold pack to affected area to help with pain and to assist in constricting blood vessels. Also helps to keep the infiltration localized.
  • Wrap a cold terry cloth around some ice or dampen cloth with cold water and apply it to the IV site.
  • Ice packs are applied to site for 20–60 minutes and repeated three times a day until swelling is gone.
  • Radiologist must be informed and will provide treatment orders (this may include a plain x-ray of the IV site to look for contrast).
  • An estimate of the amount of contrast delivered is important, so know the approximate amount prior to speaking to the radiologist.
  • An incident report must be completed and the patient, once discharged by the radiologist, should be sent home with written instructions of post procedural care. (E.g., the radiologist’s written instructions describe if or why the patient would need to seek additional medical attention.)
19
Q

what’s a bolus injection?

A

rapid intro of contrast medium into vascular system

20
Q

what 5 factors control the rate of a bolus injection?

A

The rate of the bolus injection is controlled by:

  1. Gauge of needle and connecting tube
  2. Amount of contrast required for the injection
  3. Viscosity of contrast agent
  4. Stability of the vein
  5. If a manual injection is performed, the force applied depends on the individual administering the injection. Power injectors use a set PSI (pounds per square inch) to regulate force of injection.
21
Q

2 Advantages to scheduling the same patient for multiple exams in one day

A
  • Less time taking up a bed
  • If you’re lucky the patient only needs to be prepped once for multiple exams which is good because exam prep can have an impact on overall patient health
22
Q

3 Disadvantages to scheduling the same patient for multiple exams in one day

A
  • Increased potential for miscommunication (particularly sequence).
  • Can be difficult to coordinate communication over exam times with porters/units.
  • All staff doesn’t have knowledge of numerous imaging department exam procedures
23
Q

What happens if we mess it up? (4 things.)

A
  1. Barium residue from GI exams can mess up urinary tract exams.
  2. Barium residue can mess up ultrasound and C T exams. C T is high dose radiation and you don’t want an unnecessary exam (benefit outweighs the risks).
  3. Incorrect diagnosis, especially with some NM exams, like if a patient gets iodinated contrast before a thyroid NM exam, they have to wait 3 weeks to have the exam repeated. That can be long time for cancer patients.
  4. Each institution has procedures to help plan exam scheduling, but untrained staff might not know the significance of the prep and incorrectly prep patients. Poor prep can result in suboptimal exam or even misdiagnosis. Like, if a patient can’t swallow oral contrast they need an NG tube to get it in there. Takes coordination with patient’s physician and nursing staff.
24
Q

Which order should exams be booked in? (7 things.)

A
  1. Xray exams without contrast.
  2. Ultrasounds.
  3. Nuclear scans of liver/spleen.
  4. Thyroid scans before iodinated contrast exams.
  5. Iodinated contrast stuff before barium stuff
  6. Lower GI (barium enema).
  7. Upper GI (UGI or OS&D).
25
Q

Which patient goes 1st? (3 considerations)

A
  1. Those who have been fasting (especially diabetics)
  2. ER patients
  3. Pediatric and geriatric
26
Q

Other booking considerations (3 things).

A
  1. Mobility of patient.
  2. Ability to follow instructions (ESL or hearing impaired or cognition impaired).
  3. Are they accompanied? Like a nurse or respiratory therapist. These people have multiple charges to care for, be considerate of this.

Pt Care 2 (6 decks)

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