Chapter 16

Intravenous Iodinated Contrast

Why use IV Contrast

• __________ System

• __________ System

• CT

Terms to know

• ____________– To separate into ions; to dissociate atoms or

molecules into electrically charged atoms

• ____________ – The capability of being dissolved

More Terms• ____________

– Movement of a solvent across a semipermiable membrane from a lower region to a higher region

• ___________– The number of dissolved ions in a solution.

The concentration of a solution.

• ____________ Pressure– The force that a dissolved substance exerts

on a semipermeable membrane.

More Terms

• ___________ –No change in cell volume.

• ___________– Increase in osmotic pressure.

• ___________– Decrease in osmotic pressure

• ___________– The ability of a fluid to flow easily

Iodinated Contrast

• Iodine ______

• 2 types– _____________

Ionic ContrastStructure

• Basic structure is 6 sided ring with: – __________iodine atoms

– Negatively charged __________ • Stabilizing and detoxifying the contrast

– Positively charged ___________• Salts, increases solubility of the contrast

Ionic Contrast

• Breaks apart into __________– Anion

– Cation

• ____________– 3 iodine particles

– 2 osmotic particles

Ionic Continued

• Increase ____________

• Increase __________ Pressure

• Hypertonic

• ___________ chance of a reaction

Non-Ionic

• Same basic structure

• Replaces side chains with ____________ elements.

Non-Ionic Contrast

• _________break apart.

• Decreased ________– Decrease chance of a reaction

• ___________

Prior to injecting

• GET AN _________________CONSENT!!!• Thorough history needs to be obtained

– Any __________– Iodine sensitivity– Sickle Cell– ___________ problems (Stones don’t count)– __________, hay fever– Prior reaction with X-ray contrast– ___________– On Metformin (Glucophage)

Prior to Injecting Con’t

• BUN and Creatinine levels:

– Creatinine - ________________

– BUN – _________________

If there are contraindications

• Notify ______________

• May still be possible with _________

Drawing up the contrast• Is it the right __________????

• _____ contrast to _______ viscosity

• Use only sterile needles and syringe

• Draw up protocol developed amount

• If pt already has an IV line– ___________port and inject

Common feelings

• During injection– __________feeling (due to osmotic events)– Metallic taste– __________

• Watch for _____________

Reactions

• Generally happen within first __________.

• Stay with the patient at a minimum __________

• Talk with the patient and watch for any signs.

Reaction Categories

• ______ - Vasomotor Effect

• _________ - Anaphylactic Reaction

• _________ - Vasovagal Reaction

• _______________

Vasomotor EffectMild

• Technologist can assist– _________– Nausea / Vomiting – Mild, scattered Hives (uticaria)– _____________– _____________– Extravasation

• Symptoms pass __________

AnaphylacticMild or Moderate

• Technologist calls for help– ____________ urticaria (hives)– Tachycardia – _____________– Bronchospasm– Angioedema– ______________– Excessive Vomiting

Vasovagal Severe

• Technologist calls for help __________– Hypotension– ________– Cardiac or respiratory arrest– Loss of consciousness– ___________– Laryngeal edema– ______________– Difficulty Breathing– Shock

Organ-SpecificSevere

• _________ – No Pulse

• Respiratory - Pulmonary Edema

• Vascular - Thrombosis

• ____________ - Seizures

• Renal - Complete or Temporary failure

• May not show ___________ symptoms

Prepare for a reaction

• Make sure informed consent is signed

• Approx ______________die– Current practice uses ________ only

decreasing the chance

• Know reaction protocol in department

Preperation

• Know where the ___________is and have it accessible.

• ____________leave the patient alone

• If need be ______________

Post injection

• Monitor pt for __________

• Continue with exam

• Normal kidney will excrete _________ of contrast within _______

What else to watch for

• _______ will show once contrast if filtered through

• A ________ could block contrast progression