Contrats Media Reactions Flashcards
What are risk factors associated with contrast media
Nearly all contrast reactions involve IV ICM ( allergy like reactions)
Post-contrast acute kidney injury (PC-AKI)
What is post contrast acute injury
-It’s a contrast Induced nephrotoxicity
-Could be permanent or temporary
-Adverse affects of other medications that are used at the same time
What are some contrast reaction risk factors
-High probability of reduced kidney function
- higher likelihood of an adverse contrast reaction
- contraindicated medications
- recent contrast exam
What is damage to the kidney by contrast called
Contrast induced nephrotoxicity ( CIN)
What are conditions associated with reduced renal function
Diabetes
Chemotherapy
Multiple myeloma
CHF
Sickle cell
Older than 60
What are atopics
Individuals with a history of allergic reactions to foods & medications have a higher risk of having an allergic reaction to ICM
What complications will asthmatics have
A severe respiratory complication
What complications will people with cardiovascular disease
Perfusion/hemodynamic complications
How long after contrast exam should you wait on oral diabetic medication
Resume after 48 hours
What is the BUN & Creatinine test
Blood urine nitrogen (8-25mg/100mL)
Creatinine (0.6-1.5mg/dL)
- metabolic byproducts eliminated by functioning kidneys
What is the GFR
(ACGW)
Glomerular filtration rate
Uses multiple factors
-creatinine levels
- age
-gender
- weight
60+ is normal
Less than 30 severely low
What medications do you use for pts with history of allergic reactions to IV ICM
Prednisone ( corticosteroid/ suppress immune system)
Diphenhydramine ( an histamine
What possibly lowers seizures during myeolograms
SSRI’s and other anti depressants
repeated contrast exams lead to what
elevated risk of contrast induced nephrotoxicity (like 2 exams within 24 0r 48 hours)
How is IV ICM eliminated
By the kidneys
When should pretreatment oral meds and IV meds be given
oral : 12+ hours before
IV: 4+ hours before
What are signs and symptoms of extravasation
pain
swelling
redness
no blood return from IV
How do you treat an extravasation
remove needle/ canula
elevate extremity
apply cold compress
Notify
Document
What kind of reactions are IV ICM
anaphylactoid (mild)
experience rash, warmth sensation
most reactions occur after 20 minutes
What is intradermal pre testing
injecting a small amount of contrast under the skin to see of the patient has a little reaction
How are contrast reactions categorized
mild
moderate
severe
what are signs and symptoms of a mild reaction
itching
rash (urticaria)
warm sensation
nausea
vomiting
what does ‘self-limiting ‘ mean
will resolve w/o intervention
what are signs and symptoms of moderate allergic reactions
Angioedema (face swelling)
Wheezing
Hoarseness
treatment often necessary to prevent severe reaction
What are signs and symptoms of a severe reaction
Dyspnea
Hypoxia
Hypotension
Tachycardia
Shock
when is contrast cleared from the mother
24 hours
can wait 24 hours before resuming if they want
Does contrast media effect pregnancy
no evidence of harm
no evidence that’s its safe either
