Patient Care

Question 1

temperature

Answer 1

oral: 98.6
tympanic +1
axillary -1
rectal +1

Question 2

pulse rate

Answer 2

60-100 bpm

Question 3

blood pressure

Answer 3

systolic: 100-120
diastolic: 60-80

Question 4

respiratory rate

Answer 4

12-20 breaths per min

Question 5

pulse oximetry

Answer 5

90% to 100%

Question 6

P wave

Answer 6

electrical activity through atria

Question 7

QRS complex

Answer 7

movement of electrical impulse through ventricles (systole)

Question 8

ST segment

Answer 8

ventricle contracting, no electrical activity

Question 9

T wave

Answer 9

ventricles are resetting electrically (diastole)

Question 10

Kidney function tests

Answer 10

BUN; creatnine; GFR

Question 11

BUN

Answer 11

blood urea nitrogen
normal: 7-21 (higher is lower functioning)
above 50 might mean renal failure

Question 12

creatnine

Answer 12

normal: 0.7-1.5

above 1.5 is indication kidneys are not fit to filter out iodinated contrast

Question 13

GFR

Answer 13

glomerular filtration rate
normal: 90-120
GMR below 90 is indication of low function

Question 14

water-soluble iodine

Answer 14

• only contrast agent that is safe for IV injection
• will be ionic or non-ionic
• will be high or low osmolar

Question 15

ionic contrast

Answer 15

• contrast agent molecule will break apart in fluid

- individual particles will become charged

Question 16

non-ionic contrast

Answer 16

• contrast agent molecule will not break apart in fluid

- more desirable because less damaging to body

Question 17

osmolarity

Answer 17

concentration of particles in a fluid

-we want an osmolarity that is as close to that of blood (around 300 mOsm/L)

Question 18

Premed for contrast

Answer 18

commonly uses corticosteroid (prednisone) or anti-histamine (Benadryl)

Question 19

Extravasation

Answer 19

leakage of contrast outside of the vessel (most common contrast complication) which causes swelling, tightness, or burning at the site of injection

Question 20

Steps to take after extravasation

Answer 20

• inform radiologist
• elevate extremity
• apply hot and cold compresses

Question 21

Mild reactions to contrast

Answer 21

• scattered hives
• pruritus (itching)
• rhinorrhea (runny noes)
• coughing

Question 22

Steps to take after mild reaction to contrast

Answer 22

• monitor patient for 20-30 minutes
• check vital signs
• antihistamine (will be given by doctor)

Question 23

Moderate reactions to contrast

Answer 23

• diffuse hives
• persistent vomiting
• laryngeal edema (swelling of throat)
• tachycardia

Question 24

Steps to take after moderate reaction to contrast

Answer 24

• monitor patient for 20-30 mintues
• check vital signs
• ensure secure IV access
• antihistamine (will be given by doctor)

Question 25

Severe reactions to contrast

Answer 25

- altered mental status - pulmonary edema - laryngeal edema - life-threatening tachycardia - death

Question 26

Steps to take after severe reaction to contrast

Answer 26

- code blue (immediately) | - epinephrine (will be given by doctor)

Question 27

Order of events for ALL contrast reactions

Answer 27

1. discontinue contrast 2. call for nurse and physician immediately 3. assess patient's ABCs (airway, breathing, circulation) 4. acquire vital signs 5. prepare reaction kids and O2 6. prepared to call a code blue

Question 28

nephrotoxicity

Answer 28

decrease in renal function following IV contrast administration

Question 29

risk factors for nephrotoxicity

Answer 29

- preexisting renal insufficiency - diabetes - dehydration - heart disease - diuretic use - age - multiple myeloma

Question 30

barium sulfate

Answer 30

used almost exclusively for GI system

Question 31

Enteral

Answer 31

goes into GI tract without being absorbed by body

Question 32

parenteral

Answer 32

intrathecal, intra-articular, intravenous

Question 33

intrathecal

Answer 33

ex: myelograms

Question 34

intra-articular

Answer 34

ex: arthrograms

Question 35

intravenous

Answer 35

ex: IVP, urograms

Question 36

most common contraindication for barium sulfate

Answer 36

perforated bowel