RAD Procedures Exam 3

Need-to-know about medications (5 things)

name, dosages, indications, contraindications, and adverse reactions

anxiety can cause __________ making puncture more painful

vasoconstriction

4 different types of vascular access devices

peripheral IV line, central line, PICC line, port-a-cath

what is the most commonly used vascular access device

peripheral line

a catheter placed into internal/external jugular vein, chest (subclavian vein), or groin (femoral vein)

central line

what vascular access device is used to administer medication or fluids

central line

a peripherally inserted central catheter

PICC line

PICC Line

a central venous catheter inserted into the arm rather than a vein in the neck or chest

what is a port a cath

a small medical appliance that is surgically installed beneath the skin

what connects the port to a vein in a port a cath

a catheter

where is a port-a-cath usually inserted

in the upper chest below the clavicle

what are ports mostly used for

to treat hematology and oncology patients

which part of the needle attaches to syringe

the hub

which part of the needle is the length of the needle

cannula or shaft

which part of the needle is the slanted portion at tip

bevel

which part of the needle is the diameter or needle bore

gauge

types of needles

hypodermic, butterfly sets, angiocatheters

what is an over-the-needle cannula

it allows catheer to slip off needle into the vein and the steel is removed

what needle is usually used by radiographers for IV administration

butterfly sets and angiocatheters

whats the rule on syringe size

size should be one size larger than volume injected

site selection general rule

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

during administration of medication, infiltration or extravasation means:

fluid has entered tissues instead of vein

3 complications/reactions of contrast

mild, moderate, severe

mild reactions include:

sensation of warmth, metallic taste, sneezing

moderate reactions include

nausea, vomiting, itching

severe reactions include

anaphylactic shock, cardiac or respiratory distress

infiltration or extravasation is a complication and its symptoms include

swelling, redness, burning, pain

5 rights of medication administration

right patient, right medication, right route, right amount, right time

Which of the following are suitable veins for venipuncture?

A. Median cubital

B. Cephalic

C. Basilic

D. All of the above

D. all of the above

All of the following are moderate reactions to contrast,

except:

A. Metallic taste

B. Nausea

C. Vomiting

D. Itching

A. metallic taste

urinary system is also called the:

excretory system

what shape are the borders of the kidneys

convex lateral borders and concave medial borders

which kidney is slightly longer and narrower

the left kidney

is superior or inferior aspect of kidney more posterior

superior

the kidneys lie in what degree of an oblique plane

30 degrees anteriorly toward aorta

where do the kidneys extend from

T12-L3

which kidney is lower

right slightly lower

renal capsule

outer covering

renal cortex

outer layer of renal tissue

renal medulla

inner layer of renal tissue

what is the renal medula composed of

8-15 cone-shaped segments of collecting tubules

renal columns

extensions of cortex between renal pyramids

the essential microscopic component of kidney

nephron

glomerulus formed by:

tiny branch of renal artery entering capsule and dividing into capillaries

vessel entering capsule

afferent arteriole

vessel exiting arteriole

efferent arteriole

what is the glomerulus

a filter for blood, allowing fine particles and water to pass into the capsule

calyces

cup shaped stems that enclose one or more papilla

when united, what do major calyces form

renal pelvis

how much can an adult bladder hold

500 ml

prostate

small glandular body surrounding the proximal part of the male urethra

2 components of a nephron

renal corpuscle and tubule

trigone

triangular area of bladder base between three openings

what are the two filling techniques for the renal parenchyma contrast studies

antegrade (IVU, IVP) and retrograde (cysto)

antegrade

contrast medium enters the kidney in the normal direction of blood flow

retrograde

contrast material is introduced against the normal flow

bladder study contrast media

lower concentrations required because of large amount required to fill bladder

which media is less likely to cause an adverse reaction in bladder studies

nonionic media

what does a clear demonstration of urinary system requires what?

GI tract to be free of gas and fecal material

if a patient is dehydrated, what does this put them at an increased risk of during a contrast study

contrast medium-induced renal failure

what is needed for excretory urography and most retrograde studies of the bladder and urethra

standard radiographic room

what is needed for retrograde urographic procedures that require cystography

combination cystoscopic-radiographic unit

what is required for infusion nephrourography

tomography

procedural considerations

image quality, motion control, respiration, scout examination

soft tissues that must be defined in study

• sharply defined outline of kidneys

• lower border of liver

• lateral margin of psoas muscles

when should exposure be made for urinary system radiography

the end of expiration

what is the scout image used for

to reveal extrarenal lesions that could cause symptoms making urinary studies unnecessary

intravenous urography is also called

excretory urography

what does intravenous urography represent

structure and function of kidneys

why would intravenous urography be used

evaluate suspected or continues presence of ureteral obstruction

normal creatinine

0.5-1.2mg/100mL

normal glomerular filtration rate

90-120 mL/min/1.72m2

what GFR represents renal dysfunction

90 mL/min or less

postvoid radiograph of bladder may be taken in IVU examinations why

to check for small tumor masses or enlarged prostate in male patients

which one is postvoid

the right

what does retrograde urography require

catheterization of ureters

what does retrograde urography provide

improved opacification of renal collecting system

indicated for evaluation of collecting system in patients with:

renal insufficiency or contrast sensitivity

what is retrograde urography classified as

an operative procedure

what is performed in a specifically equipped cystoscopic radiographic examining room

retrograde urography

retrograde urography patient position

supine on cystoscopic table, knees flexed over stirrups

what 3 AP projections for retrograde urography

preliminary image, pyelogram, ureterogram

patient position for AP urinary system to demonstrate opacified bladder and kidney mobility

upright position

where is CR centered for the AP urinary system

the iliac crests

what structures does the AP urinary system show

kidneys, ureters, and bladder filled with contrast medium

what is superimposed on the AP urinary system

superimposing intestinal gas

evalutation criteria AP bladder if needed

prostate area in male patients, labeled postvoid images showing residual contrast medium

what is this a projection of

AP Bladder

what is this a projection of

AP urinary system

in an AP oblique urinary system which kidney is perpendicular to plane of IR

the kidney closer to IR (downside kidney)

in an AP oblique urinary system which kidney is parallel with the IR

the kidney farther from the IR (elevated kidney)

MCP rotated how when taking an AP oblique urinary system

30 degree angle

where does CR an AP oblique urinary system

approx 2 inches lateral to midline on elevated side at level of iliac crest

what is this a projection of

AP oblique urinary system

what has NO superimposition on the AP oblique urinary system

the kidney farther from the IR on the spine

what is this

cystography

cystography usually performed via:

retrograde contrast administration

Indicated for:

• Vesicoureteral reflux

• Recurrent lower urinary tract infection

• Neurogenic bladder

• Bladder trauma

• Lower urinary tract fistulae

• Urethral stricture

• Posterior urethral valves

cystography

contraindications for cystography

related to catheterization of the urethra

the first cystogram has the patient in what position

supine