FINAL EXAM - REVIEW Flashcards
Some Major complications of NORA
Unintended patient Awareness (Gastroenterologic locations) Anaphylaxis Need to upgrade of care SERIOUS hemodynamic instability Central and peripheral venous access Vascular access related complications Wrong patient and wrong site Fall or burn
NORA: Minor complications in order of frequency
PONV Inadequate pain control Hemodynamic instability Post dural puncture Complications related to central and IV lines
Principles of Radiation safety include
Time, distance, and shielding
Occupational exposure to radiation can be minimized by the “4 D’s” strategy.
1) Limit the Duration of exposure.
(2) Increase the Distance from source (the inverse square law)
(3) Use protective shielding such as lead-lined garments or protective shields-Deflect the radiation.
(4) Use a Dosimeter to monitor exposure.
Life time radiation exposure
50 mSv in any 1 year and a lifetime limit of 10 mSv multiplied by the individual’s age in years.
STAFF to monitor their cumulative exposure to radiation
Individual dosimeter badges
Since X-rays obey the inverse square law, the minimum recommended distance from an X-ray source is
6 feet.
Dye Hypersensitivity reactions Tx – supportive, stop dye, fluids, pressors, O2, intubate if needed,
supportive, stop dye, fluids, pressors, O2, intubate if needed
Immediate reactions seen with IV contrast
Pruritus Urticaria Angioedema Abd pain, nausea, diarrhea rhinitis Hoarseness cough Dyspnea (Bronchospasm, laryngeal edema) Resp arrest Hypotension, CV shock cardiac arrest
Nonimmediate reactions with IV contrast
Pruritus Exanthemia Urticaria , Angioedema Stevens Johnson syndrome Graft vs host reaction
TWO main reactions possible with IV contrast?
The patient is scheduled or Computed Tomography (CT) scan with intravenous contrast media (ICM). What is your main concern?
HYPERSENSITIVIY reactions, ALLERGIC REACTION. Contrast can cause anaphylactic and anaphylactoid reactions. Renal dysfunction is possible. Patients at risk or reaction to ICM include asthmatics, numerous comorbidities, and allergic reaction
Renal adverse reaction and hypersensitivity reactions.
What indicates contrast induced nephropathy?
Contrast-induced nephropathy, Cr of 0.5mg/dL, or a 25% increase from baseline within 48-72 hours
The patient is scheduled or Computed Tomography (CT) scan with intravenous contrast media (ICM). What is your main concern?
HYPERSENSITIVIY reactions, ALLERGIC REACTION. Contrast can cause anaphylactic and anaphylactoid reactions. Renal dysfunction is possible. Patients at risk or reaction to ICM include asthmatics, numerous comorbidities, and allergic reaction
HYPERSENSITIVIY reactions
ALLERGIC REACTION. Contrast can cause anaphylactic and anaphylactoid reactions. Renal dysfunction is possible. Patients at risk or reaction to ICM include asthmatics, numerous comorbidities, and allergic reaction
What physiological changes should be expected in the patient receiving radio contrast Media?
(1) Systemic hypertension resulting from increased intravascular volume secondary to increased plasma osmolality;
(2) hypotension due to hypovolemia caused by an osmotic diuresis;
(3) osmotic diuresis (high volume urine output)
(4) nausea, vomiting and urticaria;
ACT in radiology : parameters
2-3x pt’s baseline and keep it there using heparin 50IU/kg (usually 5000)
