Special Consideration and Precautions

Question 1

Laboratory Tests

Answer 1

Creatinine Level
BUN

Question 2

Creatinine normal range

Answer 2

0.6-1.3 mg/dL

Question 3

BUN normal range

Answer 3

8-20 mg/dL

Question 4

Indicates renal function

Answer 4

Creatinine Level

Question 5

Assesses renal and liver function

Answer 5

BUN

Question 6

If either creatinie and BUN value is abnormal, —

Answer 6

notify the attending
physician/radiologist before proceeding

Question 7

Patients on (1) (for non-insulin-dependent diabetes) are at risk for acute renal failure or (2) when combined with iodinated contrast media (CM)

Answer 7

1. Metformin Hydrochloride
2. actic acidosis

Question 8

The (1) advises withholding metformin for at least (2) after the procedure to prevent adverse reactions

Answer 8

1. American College of Radiology (ACR)
2. 48 hours

Question 9

Risk Factors for Adverse Reactions to IV Contrast Media

Answer 9

1. Allergy
2. Asthma
3. Renal insufficiency
4. Cardiac status
5. Anxiety

Question 10

Checklist for Pre-contrast History

Answer 10

1. Hx of kidney disease/failure (check creatinine and BUN levels).
2. Hx of diabetes (check for metformin use).
3. Hx of heart disease or hypertension (monitor BP before and after the procedure).
4. Any prior iodinated contrast studies in the last 48 hours.
5. Allergy hx (especially to CM).
6. Hx of asthma or previous allergic reaction to contrast (inquire about the specific agent used and reaction details).
7. Current medications (focus on beta-blockers, antihypertensives, or metformin)

Question 11

Incidence of Fatal Reactions

Answer 11

Rare, about 1 in 40,000 cases

Question 12

Premedication: Patients with known sensitivities may be premedicated with (1) or (2) (e.g., (3))

Answer 12

1. antihistamines
2. corticosteroids
3. SoluMedrol

Question 13

Common Reactions to CM

Answer 13

• Feeling of warmth during injection (lasting 1-3 minutes).
• Metallic taste in the mouth.

Question 14

Vasovagal Reaction: Triggered by (1), leading to increased (2) and (3).

Answer 14

1. vagus nerve stimulation
2. vasodilation
3. cardiovascular changes

Question 15

Severe Reactions: Anaphylaxis or anaphylactic shock, which can cause (1) or (2) and, in some cases, (3). Radiographers must be vigilant for these reactions

Answer 15

1. respiratory
2. cardiac arrest
3. seizures