Chapter 14
Intravenous Iodinated Contrast
Why use IV Contrast
• ____________ System
• ___________ System
• _______
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
• ______________
• 2 types– Ionic and Non-ionic
Ionic ContrastBasic Structure
• 6 sided ring: – 3 ________ atoms
• __________ element
– __________• Negative charged
– Stabilize and detoxify
– ___________• Positive charge
– Salt, increase solubility
Ionic Contrast
• Breaks apart into _____________–Anion –Cation
• __________– Ratio–_________particles–_________particles
Ionic Continued
• Increase ______________
• Increase ____________Pressure
• Hypertonic
• ___________ chance of a reaction
Non-Ionic
• Same basic structure
• Replaces ____________with ____________elements.
Non-Ionic Contrast
• _____________break apart.
• Decreased ____________– __________ chance of a reaction
• __________ – Ratio
Prior to injecting
• GET AN _________________________!!!• Thorough history needs to be obtained
– Any allergies– ____________ sensitivity– Sickle Cell– Kidney problems (Stones don’t count)– ______________, hay fever– Prior reaction with X-ray contrast– Diabetic– On ___________
Prior to Injecting Con’t
• BUN and Creatinine levels:
–Creatinine - ______________
–BUN – _______________
If there are contraindications
• Notify ____________
• May still be possible with prep.
Drawing up the contrast
• Review your ‘6’ rights– ________– Drug– __________– Route– ___________– Documentation
Common feelings
• During injection– ____________feeling (due to osmotic events)– ____________ taste– Nausea
• Watch for _____________
Reactions
• Generally happen within first __________.
• Stay with the patient at a minimum ______________
• ________ with the patient and watch for any signs.
Reaction Categories
• Mild - ___________ Effect
• Moderate - ___________ Reaction
• Severe - ___________Reaction
• Organ Specific
Vasomotor EffectMild
• Technologist _________– Anxiety– Nausea / Vomiting – Mild, scattered Hives (uticaria)– Lightheaded– _____________– Extravasation
• Symptoms pass ___________
AnaphylacticMild or Moderate
• Technologist ____________– Excessive urticaria (hives)– ___________– Laryngospasm– Bronchospasm– _____________– Hypotension– Excessive ___________
Vasovagal Severe
• Technologist ______________!!!!!!!!– Hypotension– ______________– Cardiac or respiratory arrest– Loss of consciousness– _________________– Laryngeal edema– ________________– Difficulty Breathing– Shock
Organ-SpecificSevere
• Cardiac – ___________
• Respiratory - Pulmonary Edema
• Vascular - Thrombosis
• Nervous - _____________
• Renal - Complete or Temporary failure
• ____________show immediate 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
• Kidneys will show once _________ is filtered through
• A ______________contrast progression
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