1. Chapter 16 Intravenous Iodinated Contrast

2. Why use IV Contrast __________ System CT

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

4. 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.

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

6. Iodinated Contrast Iodine ______ 2 types – _____________

7. 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

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

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

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

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

12. 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)

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

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

15. 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

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

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

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

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

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

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

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

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

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

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

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