Chapter 16 Intravenous Iodinated Contrast. Why use IV Contrast __________ System CT.
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Transcript of Chapter 16 Intravenous Iodinated Contrast. Why use IV Contrast __________ System CT.
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