Contrast media

A substance that makes affected anatomy appear whiter compared to surrounding structures

Positive Contrast Agent

An inert positive contrast agent used primarily to visualize the gastrointestinal (GI) tract

Barium Sulfate

Water soluble contrast agents that mix readily with blood and bodily fluids

Iodinated Media

Substances such as air and gases that cause affected structures to appear darker than surrounding structures

Negative Contrast Agents

A non toxic negative contrast agent with the best characteristics for double contrast studies because it is not absorbed too rapidly

Carbon dioxide (C02)

A radiographic examination using both a positive agent and a negative agent to enhance soft tissue visualization

Double Contrast Study

The number of particles in a solution per kilogram (weight) of water

Osmolality

A measure of a fluid's resistance to flow

Viscosity

The potential of a contrast agent to cause harm to the body

Toxicity

______ dissociate into charged particles in the bloodstream, they are typically high osmolar

Ionic Contrast Compounds

_____ do not break down into charged particles, resulting in lower osmolality and fewer adverse reactions

Nonionic Contrast Compounds

An exam that historically used oil based contrast but now typically uses water soluble iodinated media

Hysterosalpingogram (HSG)

A lab value used to check kidney function with a normal range of 0.6–1.6 mg/dl

Serum Creatinine

A lab value used to check kidney function with a normal range of 5–25 mg/dl

Blood Urea Nitrogen (BUN)

A measurement of kidney function with a normal range of 95–120 mL/min/1.73m²

Glomerular Filtration Rate (GFR)

A non allergic parasympathetic response to anxiety or pain that can cause dizziness and low heart rate

Vasovagal Response

A reaction associated with physical properties of a contrast agent like volume or rate of injection

Chemotoxic Reaction

An unpredictable allergic like response caused by histamine release

Idiosyncratic Reaction

A minor contrast reaction characterized by localized hives or a rash

Urticaria

A severe life threatening allergic reaction that may include laryngeal edema

Anaphylactic Shock

A drug commonly administered to treat severe anaphylactoid reactions

Epinephrine

A drug used to treat bradycardia during a vasovagal response

Atropine

Right dose, medication, patient, time, route, and documentation

The Six Rights of Medication Administration

Medication administration via the digestive tract (oral, rectal, or NG tube)

Enteral Route

Medication administration that bypasses the GI tract (such as IV injection)

Parenteral Route

A concentrated mass of pharmaceutical preparation given all at once intravenously

Bolus

The escape of fluid from a vessel into the surrounding tissue

Extravasation

Exam Sequencing Order (6)

1. Non-contrast exams

2. Iodine uptake studies

3. Urinary tract

4. Biliary system

5. Barium enema

6. Upper GI

What is the most common agent compound we now use in contrast studies?

Non ionic contrast compounds

Serum creatinine range

0.6-1.6 mg/dl

Blood urea nitrogen (BUN) range

5-25 mg/dl

Glomerular filtration rate (GFR) range

95-120 mL/min

What do serum creatinine levels indicate?

How well kidneys filter waste

What do blood urea nitrogen levels indicate?

Waste produced from liver

If the serum creatinine number is below 0.6?

Can indicate liver disease

What does the glomerular filtration rate indicate?

How well kidneys filter blood, overall kidney function

What can cause vasovagal response

Contrast

Low blood pressure

Hypotension

Sweating

Diaphoresis

Ionic ROCM vs Non ionic ROCM, which has a higher osmolality?

Ionic ROCM

ROCM

Radiopaque contrast media

The movement of water across a semi permeable membrane

Osmosis

Osmolality controls the _____ and ____ of water between body compartments.

Distribution and movement

Osmolality and Osmolarity are often used interchangeably in reference to osmotic activity, there is a difference (one measures in weight and the other in volume), which is which?

Osmolality is weight and Osmolarity is volume

The concentration of molecules/volume of solution

Osmolarity

A highly osmotic agent will attract ____ causing a dilutional effect

Water

6 rights of Administration

Right dose, medication, patient, time, route, documentation

What veins are most commonly punctured for venipuncture?

4 veins

1. Anterior forearm

2. Posterior hand

3. Radial aspect of wrist

4. Antecubital space of elbow

General rule of site selection for venipuncture

Select most distal site that can accept the needle size and can tolerate injection rate and solution

The movement of water across a semi permeable membrane

Osmosis

A highly dense pharmacologic agent used to visualize low contrast tissues in the body

Radiopaque Contrast Media (ROCM)

The control mechanism for the distribution and movement of water between body compartments

Osmolality

The concentration of molecules per weight of water, measured in milliosmoles per kilogram (mOsm/kg)

Osmolality

The concentration of molecules per volume of solution, measured in milliosmoles per liter (mOsm/L)

Osmolarity

The effect caused when a high osmotic substance in the bloodstream attracts water to equalize pressure

Dilutional effect

The atomic number of Iodine

53

The atomic number of Barium

56

The kVp level used for blood vessels and the genitourinary tract to produce high contrast images

80 kvp

The kVp level used for GI tract (Barium studies) to penetrate contrast and visualize walls/inner structures

90 kvp

Medication administration that is not through the alimentary canal, but rather by injection

Parenteral

Symptoms such as pain, vessel dilation, erythema, and nausea caused by the rapid movement of fluid through the vascular system

Hyperosmolar ROCM effect

An unpredictable reaction mechanism that can be caused by histamine release

Idiosyncratic Reaction Mechanism

A reaction mechanism attributed to physiological properties, total volume injected, and injection rate

Chemotoxic Reaction Mechanism

An onset characterized by warmth, tingling, itching palms, throat constriction, and a feeling of doom

Severe ROCM reaction/Anaphylaxis

The tool used in CT and IR exams to deliver large amounts of IV ROCM at fast rates

Power injector