Chapter 16 Intravenous Iodinated Contrast

Why use IV Contrast __________ System CT

Terms to know ____________ –To separate into ions; to dissociate atoms or molecules into electrically charged atoms ____________ – The capability of being dissolved

More Terms ____________ – Movement of a solvent across a semipermiable membrane from a lower region to a higher region ___________ – The number of dissolved ions in a solution. The concentration of a solution. ____________ Pressure –The force that a dissolved substance exerts on a semipermeable membrane.

More Terms ___________ – No change in cell volume. ___________ – Increase in osmotic pressure. ___________ –Decrease in osmotic pressure ___________ –The ability of a fluid to flow easily

Iodinated Contrast Iodine ______ 2 types – _____________

Ionic Contrast Structure Basic structure is 6 sided ring with: –__________iodine atoms –Negatively charged __________ Stabilizing and detoxifying the contrast – Positively charged ___________ Salts, increases solubility of the contrast

Ionic Contrast Breaks apart into __________ –Anion –Cation ____________ –3 iodine particles –2 osmotic particles

Ionic Continued Increase ____________ Increase __________ Pressure Hypertonic ___________ chance of a reaction

Non-Ionic Same basic structure Replaces side chains with ____________ elements.

Non-Ionic Contrast _________break apart. Decreased ________ –Decrease chance of a reaction ___________

Prior to injecting GET AN _________________CONSENT!!! Thorough history needs to be obtained –Any __________ –Iodine sensitivity –Sickle Cell –___________ problems (Stones don’t count) –__________, hay fever –Prior reaction with X-ray contrast –___________ –On Metformin (Glucophage)

Prior to Injecting Con’t BUN and Creatinine levels: –Creatinine - ________________ –BUN – _________________

If there are contraindications Notify ______________ May still be possible with _________

Drawing up the contrast Is it the right __________???? _____ contrast to _______ viscosity Use only sterile needles and syringe Draw up protocol developed amount If pt already has an IV line –___________port and inject

Common feelings During injection –__________feeling (due to osmotic events) –Metallic taste –__________ Watch for _____________

Reactions Generally happen within first __________. Stay with the patient at a minimum __________ Talk with the patient and watch for any signs.

Reaction Categories ______ - Vasomotor Effect _________ - Anaphylactic Reaction _________ - Vasovagal Reaction _______________

Vasomotor Effect Mild Technologist can assist –_________ –Nausea / Vomiting –Mild, scattered Hives (uticaria) –_____________ –Extravasation Symptoms pass __________

Anaphylactic Mild or Moderate Technologist calls for help –____________ urticaria (hives) –Tachycardia –_____________ –Bronchospasm –Angioedema –______________ –Excessive Vomiting

Vasovagal Severe Technologist calls for help __________ –Hypotension –________ –Cardiac or respiratory arrest –Loss of consciousness –___________ –Laryngeal edema –______________ –Difficulty Breathing –Shock

Organ-Specific Severe _________ – No Pulse Respiratory - Pulmonary Edema Vascular - Thrombosis ____________ - Seizures Renal - Complete or Temporary failure May not show ___________ symptoms

Prepare for a reaction Make sure informed consent is signed Approx ______________die –Current practice uses ________ only decreasing the chance Know reaction protocol in department

Preperation Know where the ___________is and have it accessible. ____________leave the patient alone If need be ______________

Post injection Monitor pt for __________ Continue with exam Normal kidney will excrete _________ of contrast within _______

What else to watch for _______ will show once contrast if filtered through A ________ could block contrast progression