Contrast Media Test 3 Review

what procedures use barium?

esophagram

UGI

small bowel

BE

what special considerations need to be given when using contrast media in children?

they are susceptible to fluid shift that can lead to cardiac failure and pulmonary edema

they use smaller volumes, small-gauge catheters and have unusual vascular access

what type of contrast media has a low atomic number?

negative

what type of contrast media has a high atomic number?

Positive

name all positive contrast medias

suspended / barium

oil-based iodinated

water-soluble

iodinated

name physical properties of barium

Atomic number 56

compound

particles in suspension

chemically inert powder

substances added

insoluble

name some reactions that require the use of Epinephrine

hives

diffuse erythema

bronchospasm

laryngeal edema

hypotension with tachycardia

hypertensive crisis

what flow rate should be set when administering oxygen during a contrast reaction?

6-10 L/min

what contrast is used for a cystogram?

water-soluble iodinated

what procedure uses gadolinium-DTPA as a contrast agent?

MRI

what are normal creatinine levels?

.5 to 1.4

what is a normal GFR level?

90-120 ml/min

how long does it take for barium to pass through the small intestine when taken orally?

1 hour

name several specific diseases you should screen for increased risk with water-soluble iodinated contrast

asthma

allergies

CAD

hypertension

renal disease

Multiple myeloma

sickle cell

COPD

diabetes

name the types of contrast used for a double-contrast arthrogram

water-soluble iodinated and air

name the types of contrast used for a double-contrast barium enema?

barium and air

what is the risk of performing a barium enema on a patient who has diverticulitis or ulcerative colitis

possible colon perforation

how is water-soluble iodinated contrast eliminated from the body?

excreted through the kidneys

how is barium eliminated through the body

excreted through the rectrum

what procedure uses gas-filled micro bubble as a contrast agent

ultrasound

what type of contrast is used if the patient has a suspected bowl perforation?

Water-soluble iodinated alternative

what contrast is used for a myelogram?

only non-ionic water-soluble iodinated

what contrast is used for a UGI

barium

name the cations

sodium and meglumine

define osmolality

the number of particles in solution

if a contrast media has an osmolality level of 1500 most/kg, what type of contrast is it?

high osmolar, probably ionic water-soluble iodinated

what is an advantage of using non-ionic contrast over ionic contrast?

less chance of radiation

what treatment is needed for a moderate reaction?

require close careful observation and often treatment but no hospitalization

what treatment is needed for a severe reaction?

prompt recognition and treatment

almost always need hospitalization

what type of reaction would a patient be given Benadryl?

urticaria

what can be done to lower the viscosity of iodinated contrast media?

heat the medium to body temperature

if your patient has coronary artery disease, what is the risk of using water-soluble contrast media?

tachycardia

bradycardia

hypertension

MI

what type of contrast has anions and cations

ionic water-soluble iodinated

what type of contrast media disassociates upon injection?

ionic water-soluble iodinated

T/F: non-ionic contrast does not have iodine

False

how is contrast administered for a cystogram?

through a urinary catheter

how is contrast administered for an IVP?

intravenously

what type of a reaction is facial edema without dyspnea?

moderate

what type of reaction is nasal congestion

mild

what type of reaction is protracted nausea and vomitting

moderate

what type of reaction is isolated chest pain?

moderate

what contrast is used on an esophogram?

barium

in what order should the following exams be ordered: UGI, IVP, acute abdomen series, BE?

acute abdomen, IVP, BE, UGI

what does it mean when we say barium is a compound written BaSO4?

It contains 1 atom of barium

1 of sulfur

4 oxygen

what is the main advantage of using non-ionic contrast media?

Less chance of reactions

what type of reaction is transient flushing/warmth/chills?

mild

what drug is given to treat pulmonary edema?

lasix / diuretic

what is viscosity?

it is the friction of a medium, influenced by the concentration and size of the molecule. It affect injectability

what patient prep is needed for an UGI?

NPO after midnight before examination

what category of reaction requires observation but usually no treatment?

mild

patients with what disease could end up in renal failure from a contrast injection?

multiple myeloma

what adverse reactions can occur with negative contrast media?

usually minimal, but air can cause an emboli, with pain and loss of oxygen to the area

name 3 drugs that can cause interaction with iodinated media and what problems can result

beta adrenergic blockers

calcium-channel blockers

metformin (glucophage)

what can be done reduce or eliminate allergic effect to contrast media?

premeditate with steroid and antihistamines

how can high osmolality contrast effect the kidneys

it can cause arterial expansion, then vasoconstrictors cause constriction, which cuts off blood supply.

also renal tubules cannot reabsorb some molecular substances.