CT PREP - Ch. 2 pt care

your mom

What kind of consent - When risks, benefits and alternatives of procedure are explained to the pt

informed, radiation risk, could find a embolism, could do without contrast

Consent when pt is in immediate need of med car but is uncon or unable to consent

implied

communication is key and should begin during the _______/________

scheduling/screening

Before contrast studies pt should be instructed to take a

piss

_________ ________ is another way to immobilize pt

bref holt

Vita l signs are (4)

Temp, pulse, respiratory rate, BP

What is normal range for:

Temp

pulse

resp rate

BP

97.7 - 99.5F

60-100 BPM

12-20 Brefs per minute

120/80

pulse ox measures ______status. Specifically the _______level of blood, which should be between ______and______%

respiratory, O2, 95 - 100

vital signs are? (4) , Normal range for each is?

temp, puls, BP, resp

Temp - 97.7 - 99.5
Pulse - 60-100 BPM

BP - <120/80

Resp - 12-20 kids 20-30

atrial diastole is associated with _____wave

Ventricular systole is assoc with ___ ___ ___wave

atrial and vent diastole associated with ___ wave

P

QRS

T

Cardiac CT images are acquired during systole/diastole? Particularly the ___wave

Diastole

T wave

pts with with slower heartbeats yield good/shitty images?

good

what type of drugs are used to slow heart rate? What is preferred heart rate for cardiac CT imaging?

B-adrenergic, 65

what number of slices may preclude the need for heart slowing dugs?

64

sublingual _______can be used to cause dilation/contraction of vessels

nitroglycerine, dialation

Norma BUN, Creatinine and GFR numbers, BUN creat ratio

BUN - 7-25 mg/dL

Creat - .5 - 1.5 mg/dL

GFR - 70 mL/Min/m2 plus or minus 14 mmms for women, mens - 60 plus or minus 10

what does prothrombin measure and what is normal range?

blood coag, 12 to 15 secs

prothrombin time range

.8 - 1.2

platelet count range

140K - 400K per mm squared or uL of blood

D-dimer tests for

deep vein thrombosis, and PE - protein fragments from degraded blood clots

coumadin or warfarin is a ______ ______

anti-coagulent, special care must be taken to avoid excessive bleeding with Iv removal

Metformin or Glucophage or should not be taken ____ days before CT exam. Contrast can cause _______of it in the blood

2, retention

Look at IV site pic page 9

IV pokers must observe a_____ technique. It includes 3 things

hand wash, gloves, clean site with alcohol moving from center to outside

exams that require sterile technique are invasive, they include (3)

biopsy, aspiration,

sterile technique involves establishing a ______field around procedure and use of __________tools

sterile

Bolus injection can/cannot be done by hand

can

iv should be metal or plastic for CT?

plastic

what gauge is suitable for contrast inject?

22

how do you check for patency of vein?

backflow of blood into iv

2 types of con agenst

pos and neg

positive con agents are radi_______, degree of opacity is directly proportional to the contrast’s concentration of _________

opaque, iodine

RCM can be injected into ______and______

blood vessels, intrathecal space

what is used to show GI tract?

barium sulfate

osmolality means propensity to cause fluids _____of blood vessel to move _______

outside, inside

ionic contrast is a salt containing three _______atoms, which dissociate into 2 _______

iodine, charged particles or ions.

ionic contrast has high/low osmolarity. 2 examples

high. HOCM- high osmolar contrast medium. meglumine -Conray and diatrozoate sodium -Hypaque

non ionic con does/doesn’t dissociate when injected. 2 examps

does not. Omnipaque, Isovue

ionic or non ionic are most likely to produce side effects

ionic

iso-osmolar contrast has same _______as blood, therefore more/less potential for side effects. example

osmolarity, less, Visipaque

Enteral RCM are put in the______or up the_______ to look at the______

mouf, butthole, gi trac

enteral RCM are water soluble ______solution or__________

iodine, barium

RCM can be put into 4 places

veins, joints, intrathecal space gi tract

osmolarity is the amount of _____s in a fluid

solutes

low or high osmolarity contrast is more likely to cause side effects

high

each molecule of ionic contrast contains how many molecules of iodine.

3

the production of two osmotic ions is indicative of high ________contrast media. two types are

osmolar, conray optiray

Low osmolar contrast does/does not dissociate into two ionic molecules

does not

generally an internal agent is either water-soluble _______solution or _______ sulfate

iodinated, barium

contrast takes between ____and_____minutes to move thru the GI tract

30 - 90

barium sulfate may/may not be used when bowel perf is suspected

not

barium enemas are used to image the _____colon and

distal , rectum

air gases and water are positive/negative contrast media? iodine and barium are pos/neg?

neg, pos

bowel wall is better enhanced with neg/POS con?

neg - air, water or gas

CT imaging at the end of full resp (bref hold) improves/degrades image quality

improves

neg/POS/neutral con may be used to opacify the small bowel during enterocyclis and enterography

neutral

volumen is a ___% solution of barium. used to image small/large bowel

.1, small

IV con is admined thru a ___to_____gauge needle

18 to 23

an IV cath placed in a vein is called an _____________

angiocatheter

rcm are usually admined in doses between _____to______ ml. dose depends on ______, _______and________function

50-150, age weight and renal func

subclavian lines, PICC lines and access ports are common types of _________ _________ catheters

central venous

For CT exams limited to abdomen, administer 300mL 30 mins before/after scan. Admin 150 mL immediately before/after scan

before, before

For and AND pelvic exams admin _____mL 60-90 mins before, ____mL 30 mins before and 150 ______before

450, 300, immediately

to look at the rectum admin contrast orally _____to____hrs before OR shoot it_____ ______ ______

4 to 6 up the butthole

intrathecal admin of iodinated contrast means shooting it into the space surrounding the______ ______

evaluates spinal cord and _________roots

spinal cord, nerve

4 H’s of contrast admin:
History of ______reactions

Hydration - before during and after especially for ______compromised individuals

HAve _______and______ready to deal with contrast reactions

Heads up - watching out for _____reactions to contrast

allergic, renally, equipment and expertise, allergic

Physiologic and pathologic that may increase of adverse reacs include

Enviro/food allergies

Asthma

Renal disease

Myeloma

Diabeetus

Pherochromocytoma

sickle cell disease

hyperthy

cardiac disease

contraindi for iodine con are (2)

allergy to it, renal insuff or failure

io con can/cant cross placental barrier?

Adverse reacs of fetus to contrast is known/unknown

can, unknown

Nursing moms are instructed to pump and discard milk
___ hrs after admin of con

24

mild reacs to LOCM include

Nausea/vomit

hives

warmth/flushing

altered taste

sweats/chills

nasal stuffiness

anxiety

moderate reacs to contrast include: may/will not need treatment

mild bronchspasm - treat with bronchodialator

moderate to servere hives - benadryl

vasovagal response - hypotension/fainting - treat with raised legs and IV fluids

tachycardia/hypertension

severe reacs:

profound hypotension

laryngeal edema

sever bronchospasm

pulmonary edema

cardiac arrythmia

seizure

cardiopulmonary arrest

Death

Contrast induced nephrotoxicity serious delayed reac, increased creatinine

best prevention for CIN

hydration

metformin should or should not be taken prior to CT

nope, too much strain on kids

• The _________________ refers to the spatial response of a CT scanner to a point source of radiation, indicating how well the scanner can detect and reconstruct the image of a specific slice of tissue.

• __________is crucial for understanding the resolution and quality of the reconstructed images in computed tomography (CT).

• It is typically represented as a function of the distance from the center of the slice, showing how sensitivity decreases as one moves away from the central axis.

slice sensitivity profile

slice sensitivity profile is thinner/thicker than dose profile

thinner

amount of xrays absorbed in a unit mass is called and measured in grays. < that , accounting for tissue type is called______and is measured in______

absorbed, effective Sv

CT dose index is amount of radiation received in a

slice