Chapter 14

Intravenous Iodinated Contrast

Why use IV Contrast

• ____________ System

• ___________ System

• _______

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

• ______________

• 2 types– Ionic and Non-ionic

Ionic ContrastBasic Structure

• 6 sided ring: – 3 ________ atoms

• __________ element

– __________• Negative charged

– Stabilize and detoxify

– ___________• Positive charge

– Salt, increase solubility

Ionic Contrast

• Breaks apart into _____________–Anion –Cation

• __________– Ratio–_________particles–_________particles

Ionic Continued

• Increase ______________

• Increase ____________Pressure

• Hypertonic

• ___________ chance of a reaction

Non-Ionic

• Same basic structure

• Replaces ____________with ____________elements.

Non-Ionic Contrast

• _____________break apart.

• Decreased ____________– __________ chance of a reaction

• __________ – Ratio

Prior to injecting

• GET AN _________________________!!!• Thorough history needs to be obtained

– Any allergies– ____________ sensitivity– Sickle Cell– Kidney problems (Stones don’t count)– ______________, hay fever– Prior reaction with X-ray contrast– Diabetic– On ___________

Prior to Injecting Con’t

• BUN and Creatinine levels:

–Creatinine - ______________

–BUN – _______________

If there are contraindications

• Notify ____________

• May still be possible with prep.

Drawing up the contrast

• Review your ‘6’ rights– ________– Drug– __________– Route– ___________– Documentation

Common feelings

• During injection– ____________feeling (due to osmotic events)– ____________ taste– Nausea

• Watch for _____________

Reactions

• Generally happen within first __________.

• Stay with the patient at a minimum ______________

• ________ with the patient and watch for any signs.

Reaction Categories

• Mild - ___________ Effect

• Moderate - ___________ Reaction

• Severe - ___________Reaction

• Organ Specific

Vasomotor EffectMild

• Technologist _________– Anxiety– Nausea / Vomiting – Mild, scattered Hives (uticaria)– Lightheaded– _____________– Extravasation

• Symptoms pass ___________

AnaphylacticMild or Moderate

• Technologist ____________– Excessive urticaria (hives)– ___________– Laryngospasm– Bronchospasm– _____________– Hypotension– Excessive ___________

Vasovagal Severe

• Technologist ______________!!!!!!!!– Hypotension– ______________– Cardiac or respiratory arrest– Loss of consciousness– _________________– Laryngeal edema– ________________– Difficulty Breathing– Shock

Organ-SpecificSevere

• Cardiac – ___________

• Respiratory - Pulmonary Edema

• Vascular - Thrombosis

• Nervous - _____________

• Renal - Complete or Temporary failure

• ____________show immediate 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

• Kidneys will show once _________ is filtered through

• A ______________contrast progression