Venipuncture & Contrast Media

Question 1

what emergency drugs should be available before contrast media is administered?

Answer 1

epinephrine and benadryl

Question 2

list the exams or reasons that allow radiologic technologists to perform venipuncture

Answer 2

administering contrast media, radiopharmaceuticals, IV medications

Question 3

what type of density to radiopaque contrast agents have?

Answer 3

high density

Question 4

what do radiopaque contrast agents allow to be imaged?

Answer 4

low contrast tissues such as blood vessels, kidneys, GI tract

Question 5

what are the most common contrast agents

Answer 5

barium and iodine

Question 6

barium atomic number

Answer 6

56

Question 7

iodine atomic number

Answer 7

53

Question 8

how can barium sulfate be administered

Answer 8

orally or rectally

Question 9

when imaging a patient, what is barium used to image?

Answer 9

GI disorders

Question 10

what does the barium coat in the GI tract

Answer 10

the mucosa

Question 11

when shouldn’t barium sulfate be used?

Answer 11

when a perforation of the GI tract is suspected

Question 12

if perforation of the GI tract is suspected, what will replace the barium sulfate?

Answer 12

water soluble iodine solution

Question 13

when imaging the UGI, how should barium sulfate be administered?

Answer 13

orally

Question 14

when imaging the lower GI, how should barium sulfate be administered?

Answer 14

enema

Question 15

what adds density to vascular structures and organs?

Answer 15

iodinated contrast media

Question 16

what are the five ways iodinated contrast media can be administered

Answer 16

intravenously, intra-arterially, orally, rectally, intrathecal

Question 17

the concentration of a solution expressed as the total number of solute particles per kilogram

Answer 17

osmolality

Question 18

concentration of a solution expressed as the total number of solute particles per liter in a percentage?

Answer 18

osmolarity

Question 19

measurement of the rate of flow of a liquid through a tube

Answer 19

viscosity

Question 20

which contrast media generally has a high osmolar content?

Answer 20

ionic contrast media

Question 21

what is the ratio of iodine atoms to osmotically active particles in ionic contrast media?

Answer 21

3:2

Question 22

what is the ratio of iodine atoms to osmotically active particles in non ionic contrast media ?

Answer 22

3:1

Question 23

what are the 5 rights of medication

Answer 23

right patient, right drug, right route, right amount, right time

Question 24

how many atoms per molecule do ionic and non ionic contrast media have?

Answer 24

3

Question 25

which type of contrast media has a higher chance of adverse reactions and toxicity to organs?

Answer 25

ionic contrast

Question 26

which contrast type generally has low osmolar content?

Answer 26

non ionic contrast

Question 27

when injected into the bloodstream, which contrast agent does not disassociate into osmotically active particles

Answer 27

non ionic

Question 28

which type of contrast agent has a less chance of adverse reactions and toxicity to organs?

Answer 28

non ionic

Question 29

what are the methods of administration for venipuncture?

Answer 29

hypodermic needle, butterfly needle, IV catheter

Question 30

what important information about patients should we know before administering contrast media?

Answer 30

previous reactions, asthema, seizures, renal history, diabetic metformin drugs

Question 31

what may a patient who is at risk of reactions be administered before being given contrast?

Answer 31

steroids, benadryl

Question 32

what does BUN stand for

Answer 32

blood urea nitrogen

Question 33

which lab value measures the amount of urea nitrogen in the blood

Answer 33

BUN

Question 34

what is a waste product of protein metabolism

Answer 34

urea nitrogen

Question 35

what is the average value of BUN levels?

Answer 35

7 - 20 mg

Question 36

where is urea nitrogen creatine created and where does it carry to?

Answer 36

created in the liver and carried to the kidneys

Question 37

what is the chemical waste generated from muscle metabolism?

Answer 37

Creatinine

Question 38

what % of the body's creatine is converted to creatinine daily?

Answer 38

2%

Question 39

where is creatine created and where is it carried to?

Answer 39

created in the bloodstream and carried to the kidneys

Question 40

what is the average value of creatinine levels

Answer 40

0.6 - 1.2 mg

Question 41

what should be checked on the contrast before administration

Answer 41

type of contrast, expiration date, clarity of contrast

Question 42

what angle should the needle be for venipuncture?

Answer 42

20 - 45 degrees

Question 43

after blood return with an IV how much further should the needle be pushed into the vein?

Answer 43

1/4 - 1/2 inch

Question 44

how many cc's of normal saline should be injected into the IV after venipuncture and before administration of contrast?

Answer 44

1-3 cc

Question 45

after injecting the normal saline into the IV, what should the tech observe for

Answer 45

redness, swelling, pain

Question 46

after removing the IV, how long should pressure be held on the puncture wound?

Answer 46

3 minutes

Question 47

what are the three types of reactions to contrast administration

Answer 47

mild, moderate, severe

Question 48

how long after injecting a patient with a contrast agent do reaction signs occur?

Answer 48

2 - 3 minutes

Question 49

what two types of administration are most likely to cause adverse reactions?

Answer 49

intravenously, intra-arterially

Question 50

what are some symptoms of a mild reaction to contrast administration?

Answer 50

itching eyes and nose, cough, sneezing, hives

Question 51

what should be done if the tech notices the patient having a mild reaction to contrast?

Answer 51

stop the infusion, notify the nurse and radiologist, observe the patient

Question 52

what are some symptoms of intermediate / moderate reactions to contrast media

Answer 52

throat tightness, dyspenia or wheezing, rapid pulse or breathing, chest pain, hypotension

Question 53

what should be done if the tech notices that the patient is having intermediate or moderate reactions to contrast?

Answer 53

stop the infusion, notify the nurse and radiologist, prepare medication to administer (antihistamines)

Question 54

what are some symptoms of severe reactions to contrast agents?

Answer 54

shock, seizure, cardiac arrest

Question 55

what should be done if the tech notices a patient having a severe reaction to contrast media?

Answer 55

notify nurse and radiologist, call for the emergency team, get the crash cart and the AED

Question 56

t / f Mild or moderate reactions to contrast media cannot turn into severe reactions

Answer 56

false

Question 57

what types of medications are administered to treat intermediate or moderate reactions to contrast agents?

Answer 57

antihistamines such as epinephrine or benadryl

Question 58

what response do mild reactions to contrast media require?

Answer 58

observation and time

Question 59

what response do moderate reactions to contrast media require?

Answer 59

medication and observation

Question 60

what response do severe reactions to contrast media require?

Answer 60

immediate intervention and hospitalization

Question 61

minimum hospitalization time for a patient that suffers a severe contrast media reaction

Answer 61

24 hours

Question 62

how long after intravenous contrast media administration can a reaction occur?

Answer 62

up to 24 hrs from time of injection

Question 63

what is the cause of a hematoma as a result of a contrast media complication

Answer 63

poor needle insertion

Question 64

what is the cause of phlebitis as a result of a contrast media complication

Answer 64

unclean application / extravasation

Question 65

what is the cause of tissue sloughing as a result of a contrast media complication

Answer 65

extravasation of caustic contrast material

Question 66

are veins less or more superficial than arteries

Answer 66

more, closer to surface of skin

Question 67

how long to apply pressure to puncture site after venipuncture?

Answer 67

at least 3 minutes

Question 68

if a patient is on blood thinners or coumadin (warfrin), how long to hold puncture site after venipuncture?

Answer 68

5 minutes

Question 69

which vein is mainly used for contrast media administration?

Answer 69

medial cubital (antecubital) vein

Question 70

when medial cubital vein is inaccessible, which site of venipuncture is used?

Answer 70

palmar arch on the hand

Question 71

cleaning site size and movement of alcohol

Answer 71

4 x 4, medialateral circular motion

Question 72

maximum amount of contrast a person can recieve in a day

Answer 72

500cc

Question 73

infiltration of contrast media or caustic material under the skin

Answer 73

extravasation

Question 74

if extravasation occurs with contrast media, how to treat?

Answer 74

use heating pad to decrease viscosity of contrast and allow body to process it faster

Question 75

maximum amount of time a tourniquet should be applied

Answer 75

1 minute

Question 76

three major veins in the antecubital fossa

Answer 76

cephalic, medial cubital, basilic

Question 77

vein located on the thumb side of the arm

Answer 77

cephalic vein

Question 78

what is the cause of rolling veins?

Answer 78

needle enters to the side of the vein, causing it to roll to one side

Question 79

what is creatinine produced from?

Answer 79

creatine

Question 80

who oversees the scope of practice and contrast media for radiologic technologists?

Answer 80

ASRT

Question 81

time frame for possible IV contrast reactions

Answer 81

2-3 minutes usually, but can be up to 24 to 48 hours

Question 82

itching of the nose or eyes is a indication of which type of reaction

Answer 82

mild

Question 83

coughing is a indication of which type of reaction

Answer 83

mild

Question 84

sneezing is a indication of which type of reaction

Answer 84

mild

Question 85

hives is a indication of which type of reaction

Answer 85

mild

Question 86

what to do in case of a mild reaction?

Answer 86

stop infusion, notify nurse and radiologist, observe

Question 87

tightness in the throat is a indication of which type of reaction

Answer 87

moderate

Question 88

dyspnea or wheezing is a indication of which type of reaction

Answer 88

moderate

Question 89

rapid pulse or breathing is a indication of which type of reaction

Answer 89

moderate

Question 90

chest pain is a indication of which type of reaction

Answer 90

moderate

Question 91

hypotension is a indication of which type of reaction

Answer 91

moderate

Question 92

what to do in case of moderate reaction?

Answer 92

stop injection, call radiologist and nurse, prepare to give oxygen or epinepherine/benadryl. requires treatment

Question 93

shock is a indication of which type of reaction

Answer 93

severe

Question 94

seizures is a indication of which type of reaction

Answer 94

severe

Question 95

cardiac arrest is a indication of which type of reaction

Answer 95

severe

Question 96

what to do in case of severe reaction?

Answer 96

notify nurse and radiologist, call emergency team, get code cart and AED. requires hospitalization and observation