Brainscape's Knowledge GenomeTM

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


See full index

Patient Management 2 > Lecture 2: Contrast Administration & Venipuncture > Flashcards

Lecture 2: Contrast Administration & Venipuncture Flashcards

1
Q

What is one thing that a patient should be told prior to the administration of contrast?

A

Possible adverse reactions

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

Are contrast agents drugs? Why?

A

Yes:
1. they can be absorbed into systemic circulation and
2. they may produce a physiologic response in the body

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

Why do we use contrast agents?

A
  1. To visualize areas of the body where the organ or system of interest looks like the surrounding area (homogenous).
  2. Temporarily increase subject contrast.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

True or false?

Positive contrast agents decrease density.

A

False. Adds density.

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

What are some examples of positive contrast agents?

A
  1. Barium sulfate,
  2. Gastrografin,
  3. Iodinated intravenous contrast media.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Do positive contrast agents appear white or black on an image?

A

Appear white due to their high atomic number

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the chemical formula and atomic number of barium?

A

-BaSO4
-Z of Ba = 56

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of solution is barium?

A

A suspension (Inert compound).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the common contrast agent used in imaging of the GI system?

A

Barium sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is flocculation?

A

Stomach acid can cause clumping, causing it to come out of suspension

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

What stabilizing agents are added to prevent flocculation?

A

Sodium carbonate or sodium citrate added to prevent flocculation.

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

True or false?

Flavorings/sweeteners may be added to improve palatability of barium.

A

True

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

What is the reason we use gas barium?

A

Expansion of the stomach

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

What side is the patient lying on?

A

Right side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Label 1-4

A
  1. Enema tip
  2. Enema tube
  3. Enema resevoir bag
  4. Ballon with inflator
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When is Barium sulfate contrast media contraindicated?

A
  1. If perforation of the digestive tract is suspected.
  2. If patient is sedated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

True or false?

Barium is absorbed by the body.

A

False; not absorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What happens if contrast enters the peritoneal cavity?

A

It would require to be surgically removed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What would happen if barium in the peritoneal cavity was not removed?

A

If not removed, it can result in barium peritonitis which is highly fatal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If perferiation of the bowel suspected, what contrast agent should you use?

A

A water-soluble iodinated contrast (gastrographin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If barium is seen in the trachea, should we continue with the study?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

True or false?

If barium enters the vaginal canal, it will go into the peritoneum.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the issue with this patient?

A

Contrast in the peritoneal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is Vaginal rupture a result of?

A

Due to incorrect placement of the enema tube/catheter.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How does barium enter the peritoneum throught the vaginal canal?

A

Through the fallopian tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What should you do if a patient in need of rectal contrast has hemmaroids/complains of hemaroids?

A

Do not insert an enema/catheter and seek radiologists adivce

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Why is age a factor that contributes to the risks of bowel perforation during adminstration of contrast?

A

Increased risk of perforation due to loss of tissue tone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What other factors contribute to the risks of bowel perforation?

A

Diverticulitis, ulcerative colitis, long term steroid therapy and recent onset of constipation or diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is one complication that a patient can have if they dont have enough fluids after contrast administration?

A

Obstruction in the bowels due to the barium becoming dry; this can lead to perforation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Precautions with barium sulfate contrast

What is hypervolemia? What can this result in?

A

-Water absorption from the colon may result in excess fluid entering the circulatory system. Causes an increase in blood volume.
-Can result in pulmonary edema, seizures, coma and death.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is one symptom of hypervolemia?

A

Drowsiness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Why should sedated patients should not undergo upper GI exams?

A

The swallowing reflex is diminished, greatly increasing the risk of aspiration (inhalation) of barium sulfate suspension with resultant barium pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are Barium sulfate allergic reactions attributed to?

A

May be attributed to preservatives in the barium sulfate preparation or by latex used in barium enema retention catheters.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the 5 most common proceedures for which barium sulfate suspensions are used?

A
  1. Esophagus
  2. Stomach; upper GI series
  3. Small intestine; small bowel series
  4. Large intestine; barium enema
  5. GI exams (CT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What common proceedures (Esophagus, Stomach; upper GI series, Small intestine; small bowel series, Large intestine; barium enema, GI exams (CT)) can be administered orally?

A
  1. Esophagus,
  2. Stomach; upper GI series,
  3. Small intestine; small bowel series,
  4. GI exams (CT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What common proceedures (Esophagus, Stomach; upper GI series, Small intestine; small bowel series, Large intestine; barium enema, GI exams (CT)) can be administered rectally?

A
  1. Large intestine; barium enema,
  2. GI exams (CT))
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is intravascular radiopaque contrast primarily used for?

A

Used to add density to vasculature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is Osmolality?

A

Is a measure of the total number of particles in solutvion per kilogram of solvent

Unit of solute concentration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What does the osmolality of a solution control in the patients body?

A

Determines osmotic pressure, which controls the movement of water in the body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

True or false

Fluid moves from high areas of concentration to low areas of concentration?

A

Fluid moves from low areas of concentration to high areas of concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the 2 general types of contrast?

A
  1. Ionic
  2. Non-ionic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Do ionic contrast medias dissociate in a suspension?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Do non-ionic contrast medias dissociate in a suspension?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What does it mean if a solution is HOCM?

A

Fluid goes into the area of injected contrast (veins, arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What type of contrast is HOCM?

A

Ionic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What type of contrast is LOCM?

A

Non-ionic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What does it mean if a contrast agent is LOCM?

A

LOCM; fluid goes out from the area of injected contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What type of contrast agent is ussually related to allergic reactions?

A

Ionic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What does it mean if a contrast agent is Isomolar?

A

No movement of fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

True or false?

Water Soluble Iodinated Contrast Media tend to have high viscosity.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the viscosity of a contrast agent influenced by?

A

Influenced by concentration of the molecule.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

How are water Soluble Iodinated Contrast Medias warmed and why are they warmed?

A

Warmed through a contrast warmer to reduce viscosity and facilitate rapid injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What are the expected side effects must be explained to the patient prior to Intravenous Contrast Media?

A
  • 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
54
Q

What are the three possible types of allergic reactions that are possible with intervenous contrast media?

A
  1. Mild
  2. Moderate
  3. Severe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is an example of a mild allergic reaction to intervenous contrast media?

A

-Urticaria (Hives)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

If a patient that needs contrast adminstration has a history of mild allergic reaction to contrast, what should be done?

A

Premedication with steroids and antihistamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are examples of a severe allergic reaction to contrast?

A
  1. Dyspnea related to laryngeal edema
  2. Seizure
  3. Cardiac arrest
58
Q

If a patient that needs contrast adminstration has a history of severe allergic reaction to contrast, what should be done?

A

Do NOT preform the exam. Contact radiologist.

59
Q

What are examples of a moderate allergic reaction to contrast?

A

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

60
Q

What is a Vasovagal Response?

A

Reaction to the procedure itself.
Patient may be experiencing high anxiety concerning the procedures and/or results that cause symptoms simular to allergic reactions

61
Q

How can we eliminate patients anxiety and prevent the vasovagal response?

A

-Therapeutic communication techniques;
a. Explain proceedure
b. Explain usual side effects
c. Allow patient to express feelings
d. Ensure patient has understanding about the purpose of exam

62
Q

What are the clinical manifestations of a vasovagal reaction?

A
  • Pallor (pale skin)
  • Cold sweats
  • Rapid pulse
  • Syncope or complaint of feeling faint
  • Bradycardia
  • Hypotension
63
Q

If a patient has a vasovagal resoponse, what should you do?

A

-Give the person a snack
-Trandelenberg position

64
Q

What are the Renal Effects of Intravenous Contrast Media?

A

Contrast Induced Nephropathy (CIN)

65
Q

What is Contrast Induced Nephropathy (CIN)?

A

A transient and reversible form of acute renal failure.

Still VERY bad

66
Q

When can Contrast Induced Nephropathy (CIN) occur?

A

If a patient who has kidney issues is given contrast

67
Q

What patients are especially susceptible due to pre-existing impaired/lower kidney function?

A

Diabetics, patients with renal disease, elderly patients (>70) and patients with a solitary kidney

68
Q

If a patient has Low egfr+high Cr+Increased blood urea nitrogen (BUN) what does that mean?

A

Poor kidney function

69
Q

If a patient has an estimated glomerular filtration rate (eGFR) <30 egfr, can contrast be administered?

A

No

70
Q

If a patient has >40 eG, can contrast be administered?

A

Yes

71
Q

If a patient has 30 < eGFR < 40, can contrast be administered?

A

Contrast with hydration; risks explained to patient by radiologist; written consent obtained.

72
Q

What is N-acetylcysteine used for?

A

-Can prevent impairment of kidney function. (additive)
-May be used in patients with high risk of renal failure if contrast is essential for scan.

73
Q

What is the exception to the administration of contrast when a patient fails a egfr test?

A

Dialysis occuring 24 hours after contrast administration

74
Q

What drug interacts with contrast?

A

Melformin

75
Q

What type of contrast interacts with melformin?

A

Non iodinated contrast agents

76
Q

What is lactic acidosis?

A

A lethal condition from a decrease in blood pH as a result of non iodinated contrast given to a patient taking melformin

77
Q

What does melformin do, and why is it harmful for a patient taking it to be administered contrast?

A

-Metformin causes increase glucose uptake by cells.
-By-product of glucose metabolism is lactic acid, which can accumulate in the system in the event of impaired renal function.

78
Q

Should melformin be discontinued prior to contrast administration?

A

Site dependant-generally 48 hours prior

79
Q

True or false?

Negative contrast agents appear white

A

False; radiolucent

80
Q

What are some examples of negative contrast agents?

A

E.g., Air/Carbon dioxide/Gas (or gas producing granules)

81
Q

True or false?

Negative contrast agents have a low atomic number.

A

True

82
Q

Are negative and positive contrast agents often used together?

A

Yes

83
Q

What are the 4 syringe types used for Parenteral Drug Administration?

A
  • Standard hypodermic syringe
  • Insulin syringe
  • Tuberculin syringe
  • Prefilled syringe
84
Q

True or false

Syringes can be prefilled.

A

True

85
Q

True or false

Syringes can be reused.

A

False; disposed after use

86
Q

What is an insulin syringe used for?

A

Insulin administration

87
Q

What is a Tuberculin Syringe used for?

A

TB tests

88
Q

What is the most common type of syringe that an MRT will be using?

A

Prefilled Syringe: Saline Flush

89
Q

Where is the Tip of a syringe?

A

Where the needle attaches

90
Q

Where is the Barrel on the syringe?

A

Where the calibration scales(ml) are printed and the part that holds the drug

91
Q

Where is the Plunger on a syringe?

A

The part that fits inside the barrel and changes the pressure inside the barrel as it is pulled in or out

92
Q

What are these?

A

Standard hypodermic syringes

93
Q

What are the three parts of a needle? Describe each part:

A
  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
94
Q

What material are needles made of?

A

Stainless steel

95
Q

How are needles sized?

A

Sized according to length and gauge

96
Q

What is the gauge (G) of a needle?

A

refers to the thickness or diameter of the needle.

97
Q

What is the length of a needle refering to?

A

Refers to the measurement in inches of the shaft portion.

98
Q

Which diameter is larger; a small gauge value or a large gauge value?

A

A small gauge value

99
Q

True or false?

Shorter needles are used for intramuscular injections.

A

False; Shorter needles are used for subcutaneous injections

100
Q

True or false?

Longer needles are used for intramuscular injections.

A

True

101
Q

What determines gauge size used?

A

The viscosity of the fluid and speed of injection

102
Q

True or false?

A larger gauge will have a faster rate of injection.

A

False; Larger gauge will have a slower rate of injections

103
Q

True or false?

Lower gauge will allow you to have a higher rate of injection.

A

True

104
Q

True or false?

The gauge stays in the patient after the needle is removed.

A

True

105
Q

Which way should the bevel be facing before insertion into the patient?

A

Bevel facing up

106
Q

What is the purpose of the bevel?

A

The bevel portion separates the tissue apart for the needle to easily pass through the tissue and penetrates the skin.

107
Q

What colour is the 18 gauge needle in CT?

A

Green

108
Q

What colour is the 20 guage needle in CT?

A

Pink

109
Q

What colour is the 22 gauge in CT?

A

Blue

110
Q

What is the needle hub attached to?

A

The needle and the plain tip

111
Q

What is the Luer-Lock Syringe?

A

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

112
Q

What is 2ml equal to in cc?

A

2cc (interchangable)

113
Q

What are the methods to recapping needles?

A
  1. Needle scoop method
    2.Needle Scoop Method (Variation)
114
Q

What method is this?

A

Needle scoop method

115
Q

What method is this?

A

Needle Scoop Method (Variation)

116
Q

What are Blunt Fill Needles used for?

A

Drawing up medication;NEVER on a patient

117
Q

If medication is to be injected through intravascular, subcutaneous or intradermal injection; what should the medication be stored in?

A

Ampule or a vial.

118
Q

What is this?

A

An ampule

119
Q

What is this?

A

A vile

120
Q

Is an ampule single use or multi use?

A

Single use

121
Q

The bag has 2 ports. What is each port for?

A

-Blue cap; For spiking IV line
-White port; for injecting medication

122
Q

Medications that are of a large volume (50 – 1000ml) are packaged in what?

A

Heavy plastic or glass containers.

123
Q

What are plastic/glass vials protected by?

A

Rubber stopper that is protected by a metal cap and a rubber diaphragm.

124
Q

Watch Lab videos

A

“Videos for lab one”

125
Q

How can contrast media be administered through IV?

A
  1. By bolus
  2. By infusion
126
Q

What is an infusion?

A

Is a larger amount of drug, fluid, or fluid containing a drug that is administered over a longer period.

127
Q

What is a bolus? (injected intravenously)

A

A bolus is a designated amount of a drug that is administered over a short period of time (contrast injector).

128
Q

True or false?

Both a bolus and infusion require veinipuncture.

A

True

129
Q

Why should the lower extremities be avoided with venipuncture?

A
  1. There is a greater hazard of embolus formation in the lower extremities related to IV infusion.
  2. Scanner is timed based on contrast return from upper extremities.
130
Q

Why should the volar side of the wrist not be used for venipuncture?

A

Because the radial nerve in the area may cause the patient extreme pain.

131
Q

Why is it better to select a larger vein for contrast administration as opposed to a smaller one?

A

There is a greater risk of extravasation in smaller veins

132
Q

Label these 4 veins:

A
133
Q

What is the Power Injection Flow Rate for a 22G needle

(exluding diffusics)

A

Up to 3cc/s

134
Q

What is the Power Injection Flow Rate for a 20 G needle

(exluding diffusics)

A

3 – 4cc/s

135
Q

What is the Power Injection Flow Rate for an 18 G needle?

(exluding diffusics)

A

5cc/s and up

136
Q

What is the beneift of using Diffusics needles?

A

Allows a higher power injection flow rate for larger gauge needles (smaller diameter)

137
Q

True or false?

Contrast agent is less likely to dehydrate an elderly patient.

A

False; Contrast agent is more likely to dehydrate an elderly patient.

138
Q

What can be done to protect elderly patients during veinipuncture from any damage?

A
  1. Smaller needle may need to be used (if you are able to)
  2. Put turniquet over the clothing
139
Q

True or false?

Extravasation of LOCM is better tolerated than that which occurs with HOCM.

A

True

140
Q

How is Extravasation of Intravenous Contrast Media treated?

A
  1. Remove the needle and apply pressure to the site.
  2. Elevate the limb to reduce edema
  3. Place a warm compress to produce vasodilation and resorption of extravasated fluid and edema.
  4. Some time later, place a cold compress to produce vasoconstriction and reduce inflammation
141
Q

What are common complications of contrast media extravasation?

A
  1. Skin ulceration
  2. Soft-tissue necrosis
  3. Compartment syndrome
142
Q

Read up on visapaque

A

Patient Management 2 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions