Methods of Patient care - big test

What does the 3-digit number represent in non-ionic contrast?

Refers to the iodine content

What does the 2-digit number represent in ionic contrast

Refers to the salt concentration

What concentration of Omni would be used for a lumbar myelogram

Omni 180

What concentration of Omni would be used for complete or cervical myelogram

Omni 300

If a patient is nervous about an exam, he/she may experience a/an

vasovagal response

Which contrast is non-water soluble

Barium

Which contrast media have higher atomic numbers

Positive

Which type of contrast is used for a VCUG (Voiding cystourethrogram)

Cysto Conray

On radiographs, which contrast is radiolucent

Negative

As medications travel through the digestive system, their potency decreases due to

The first pass effect

If there is a suspected perforation in the GI tract, which contrast would be used?

Water soluble (omnipaque)

What are the post-procedure orders for a patient after a myelogram and a LP

Myelogram: Lay with head elevated 30 degrees after exam for 6 hours

LP: Patient lays flat for one hour

A study of the bladder is a

Cystogram

What medications would be given if a patient was having a mild reaction to contrast

Antihistamine

A 25-gauge needle would have a ________ opening/diameter than an 18-gauge needle

smaller

Which medication would be used for an asthmatic attack

Aminophylline

Heparin is used to

Prevent blood clots

Which drug can be used as a vasoconstrictor and a bronchodilator

Adrenalin

Which drug is a narcotic analgesic

Morphine

Which drug is a local anesthetic

Lidocaine

During CPR, is it likely that __________ will be requested/used

Adrenalin

An injection between the layers of the skin called a (an) ____________ injection.

Intradermal

We would use non-ionic because it

has ___________ osmotic rate

lower

We would use non-ionic because it

draws ______________ fluid into the intestine

less

We would use non-ionic because it

causes ____________ in the electrolytes

less changes

What instructions should be given to a patient after a barium exam?

Drink lots of water because you may feel constipated and your stool may be white in color but that is normal.

In what situations would barium (non-water soluble) be contraindicated

Perforation, obstruction/Ileus, possible surgery

What is the prep for an upper GI

Adults - NPO 8 hrs

Pediatrics - NPO 4 hrs

Infants - NPO one feeding

When picking out a contrast for an exam, what factors should be considered?

Which organs need to be demonstrated

Patients age/weight/size

What is the patient's history and indication for the test

Describe the Seldinger technique

Most common method for IV catheterization

What is the most reliable way to reduce the possibility of reactions to contrast media?

Using water soluble contrast and getting a good allergy history

Before injection of contrast media, which of the following should be reviewed:

Patient age, BUN level, Weight, Creatinine level, allergy history, blood pressure

Circle the exam which would have priority in each case

Nucmed test or Intravenous Pyelogram (IVP)

Nucmed

Circle the exam which would have priority in each case

BE or GI

BE

Circle the exam which would have priority in each case

IVP or BE

IVP

Higher osmolarity (Ionic or non-ionic)

Ionic

Lower osmolarity (Ionic or non-ionic)

non-ionic

More viscous (Ionic or non-ionic)

non-ionic

Less viscous (Ionic or non-ionic)

Ionic

Causes less discomfort

non-ionic

Cause more discomfort

Ionic

Positive and negative charged particles

Ionic

Higher atomic number

positive

Increases the density of an organ or structure

positive

Decreases the density of an organ or structure

negative

Radiopaque

positive

Radiolucent

negative

Appears white on a radiograph

positive

Appears dark on a radiograph

negative

For IVPs or CTs with IV contrast, some patients may need BUN and Creatinine labs. What does the result indicate? Is it more of a problem if the levels are too high or too low?

Labs will indicate kidney function. It is more of a problem if they are too high because it could indicate kidney failure

What contrast would be used for a Cystogram or VCUG

Cysto-conray

What contrast would be used for an intraoperative cholangiogram

Omnipaque 300

Why are CO2 and nitrogen preferred over air and oxygen for contrast media

Less risk of embolus

Absorbed more rapidly by the body

Less irritating to the tissues

Tylenol is what type of medication

Analgesic

What does glucagon do?

Relaxes intestinal peristalsis

Reglan (metroclopramide) is sometimes used during feeding tube placements-why?

It increases GI peristalsis which helps move the feeding tube down to its proper place.

Methylprednisolone is another name for:

Medrol

Benadryl is another name for:

Diphenhydramine

Adrenalin is another name for

Epinephrine

What is your role in medication administration?

Prepare contrast or medication

Assist the physician or nurse

Parenteral route means

Any method that bypasses the digestive tract

Sublingual means

Drugs taken by mouth that can be immediately absorbed by oral mucosa when put under the tongue

How is nitroglycerine administered

Sublingual with tablet under the tongue.

What are some common sites for IM injections? Is there a difference for infants and children?

Common sites: Deltoid, Vastus lateralis or rectus femoris, upper gluteal.

IM injections are not given in the buttocks/upper gluteal for young children. Using the vastus lateralis muscle avoids the risk of sciatic nerve damage from gluteal injection.

Which method of injection would give the fastest results?

Venipuncture (intravenous)

What route is used for a lumbar puncture

Intrathecal

What type of injection is most often given into the anterior forearm?

Intradermal injection

How far above the level of a vein should be an IV bag be placed

18-24 inches above level of the vein

Lasix is a

Diuretic

Hematoma

Clotted blood outside of blood vessel

Bolus

Large dose of medication or fluid given over a short period

Urticaria

Hives (itchy, raised red welts)

Syncope

Fainting

Vertigo

Sensation that your environment around is spinning in circles

Orthostatic hypotension

Sudden drop in blood pressure that happens when you stand up from a sitting or lying down position

Orthopnea

Shortness of breath that happens when you lie flat and goes away when you sit or stand up

Hypoxia

Body tissues are not getting enough oxygen

Emesis

Vomiting

Arrhythmia

An irregular, too fast, or too slow heartbeat caused by a problem with the heart's electrical signals.

Oliguria

Producing an abnormally low amount of urine

Toxicity

Harmful effect on the tissues or organs

Osmolality

Number of particles in solution

Iodine content

Percentage of iodine in the contrast medium

Viscosity

Thickness of a substance

Miscibility

How well a contrast medium mixes with body fluids

Persistence

How long a contrast medium remains in the organ

As the iodine content decreases in a contrast medium, the contrast shows up brighter on the image.

False

It is better for the patient to use a contrast that has lower osmolality rate.

True

As iodine content increases, viscosity also increases

True

It is always an advantage to use a contrast medium with a short persistence

False

Non-water soluble contrast media must not be used for examination of

Intravascular exams

Non-ionic contrast media are less viscous than ionic contrast media

False

The advantages of using non-ionic, water soluble contrast media instead of ionic include

Low toxicity, less patient discomfort

Non-ionic contrast media have a lower osmolality than ionic contrast media

True

The substance most commonly used to provide radiographic contrast in the GI tract is

non-water soluble

Cysto-conray is a/an

water soluble (ionic)

As the atomic number of a contrast medium increases, its ability to absorb radiation

Increases

Omnipaque 180 is

water soluble (non-ionic)

Omnipaque 300 would be used for which type of myelogram

Cervical and complete

Factors that are important to evaluate when selecting contrast media are:

Miscibility, potential toxicity, viscosity