Exam 1 Flashcards
Should you use barium with patients who have problems with aspiration?
no
Why don’t you want to give barium to patients who have problems with aspiration?
you don’t want it to go into the lungs because it is an element (a rock)
Use iodine instead
drinking barium contrast is ______
semi-invasive
NPO =
nothing by mouth
What position should the patient be in for a barium enema?
sims
90% of UTIs come from _____ ______
bladder infections
what do bladder infections come from?
retention of urine
what is the number 1 cause of infection in hospitals?
urinary catheters
There are two types of radiographic contrast agents:
Positive and Negative
- decreases organ density to produce contrast
- two types: carbon dioxide & air
- complication = injection of air into the blood stream, producing an air embolus.
- gives a black (like air)
appearance on an image
Negative contrast
- increases organ density and improves radiographic visualization.
- creates a density difference such as white or opaque appearance on the image
- two types: barium & iodinated contrasts
Positive contrast
- most frequently chosen contrast
- relatively nontoxic;
however, if there is a
leakage into the peritoneal
cavity or blood stream, an
adverse reaction can occur
barium sulfate
Patient Preparation for Studies of the Lower GI Tract:
strict diet
a clear liquid diet 24 hours before examination
laxative and cleansing enemas
Patients with what condition require special pre-examination orders and instruction
insulin-dependent diabetes mellitus and non-insulin dependent diabetes mellitus
cleansing enemas are always to be ordered by the physician
true
can create dehydration
Hyperosmolar
can create fluid toxicity
Hypo-osmolar
_____ is now the most common modality used in the diagnosis of pathological condition of the lower GI tract
CT
A _____ is created by bringing a loop of
bowel to the skin surface of the abdomen
stoma
Diseases that may require stomas:
- Cancer
- Diverticulitis
- Ulcerative colitis
- Traumatic injuries
They are performed to diagnose pathology of the pharynx, esophagus, stomach, duodenum, and small intestines
upper GI tract and small bowel studies
considerations for upper GI tract and small bowel studies
- Low residue diet 2 to 3 days prior to
examination - NPO 8 hours before the examination
- No smoking or chewing gum
- If perforation or obstruction is suspected, a water-soluble iodinated contrast must be used
Approximately ___ oz of barium is ingested
by the patient for an UGI
12
refers to the insertion of a plastic, silicone, or rubber tube through the urethral meatus into the urinary bladder
Catheterization of the urinary bladder
___________ is radiography of the bladder
Cystography
requires a catheter placed at the ureters for a nonfunction radiograph of the kidneys
Retrograde pyelogram
_______ ______ are catheters from the kidney to the bladder
Ureteral stents
Catheterization is performed:
- To drain
- To instill contrast for pathologic findings
- Post surgery
a catheter which is inserted and left in place to allow continuous drainage of urine (most commonly used in radiology)
indwelling catheter
used to obtain a specimen or to empty the bladder and then removed
straight catheter
A straight or indwelling catheter
__F or __F for adult female
__F to __F on males
14F or 16F
16F to 20F
what is in a catheterization kit?
- A straight or indwelling catheter
(14F or 16F for adult female, 16F
to 20F on males) - A 10-mL syringe filled with saline
to inflate balloon (for indwelling
catheter only) - Antiseptic solution
- Cotton balls or Betadine swabs for
cleansing - Water-soluble lubricant
- A specimen bottle
A receptacle for draining urine - A closed-system drainage set of an indwelling
catheter - Sterile gloves
- Sterile drapes
- Sterile forceps
has a double lumen with an inflatable balloon at one end. One lumen is attached to the urinary bag and the other lumen is for instilling sterile water into the balloon
indwelling
single lumen, no balloon
straight
how long is the female urethra?
3-5cm or 1.5-2in
how long is the male urethra?
14-18cm or 5.5-7in
a physician’s order is needed before removing an indwelling catheter
true
Two common alternative methods of urinary drainage, could be temporary or
permanent:
Suprapubic catheter
Condom catheter
- Catheter placed directly into
bladder through abdominal
incision. Used after gynecologic
surgeries, urethral injuries,
prostatic obstruction, or chronic
incontinence or bladder control. - Reduce risk of infection as a long-
term method of bladder drainage
and facilitate normal urination
after surgery
Suprapubic catheter
- Externally applied drainage used for
males who are susceptible to UTIs or
are incontinent or comatose. - A soft rubber sheath that is placed
over the penis and secured with
adhesive material. - Changed every 24 to 48 hours
Condom catheter
- Done to diagnose pathologic changes in the bladder’s function, such as tumors, trauma, or vesicoureteral reflux due to incompetent ureteral valves
- Also demonstrates anatomic changes in the bladder floor, the posterior urethrovesical angle, and the angle of the urethra in female patients when stress is applied to the bladder
Cystography
patient considerations before cystography
- Patient is advised to restrict intake of liquids several hours before the exam.
- Notification of catheterization is made.
- Assess the patient for any allergies (iodine and other medications).
- Pregnancy and UTI are contraindications for exam.
- Bladder is filled with contrast agent, 200 to 300 mL for an adult and 50 to 100 mL for a child.
Occurs in patients who are paralyzed. A stimulus such as a full rectum or an overdistended bladder creates an exaggerated response by the sympathetic nervous system
autonomic dysreflexia
- Radiographic technique performed to visualize the proximal ureters and the
kidneys after injection of an iodinated contrast agent through the ureter. This is done with a scope by a urologist - Done to assess obstruction caused by tumors, scarring, or other pathologic conditions.
- This exam will not show renal function.
retrograde pyleogram
- If an obstructed ureter is present, this will be inserted on a temporary or permanent basis.
- They can be inserted surgically or during a retrograde pyelogram
Ureteral Stents
Explain the correct order of scheduling radiographic imaging examinations if multiple examinations are ordered.
1. Iodinated contrast studies must be performed before barium studies because the barium would obscure the iodinated contrast.
2. Procedures that require fasting must be done in the morning.
3. When a patient needs both upper and lower GI systems examined with barium the lower GI series should be scheduled first because barium clears quickly from the lower bowel.
4. All exams that do not require contrast media should be scheduled first.
5. Ultrasonography and nuclear medicine procedures must be scheduled before contrast studies, so the contrast doesn’t interfere with these exams.
2, 4, 5, 1, 3
