Urinary System-rg13
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| Why do we perform contrast studies on the urinary system? | To demonstrate the renal parenchyma using contrast media followed by x-ray or CT imaging
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| What are the 2 filling techniques used in Urinary Studies? | Antegrade—with the normal pathflow & Retrograde—against the normal pathflow
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| The_____filling technique demonstrates ______ & is usually administered thru the _______. | Antegrade, function & structure, bloodstream
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| The _____filling technique typically demonstrates _____ & is used to demonstrate ______. | Retrograde, blockage, structure
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| Imaging of the renal drainage & collecting system is called____ | Urography
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| Urography is a functional study--True/False | True (it looks at how the renal system drains)
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| What studies are considered antegrade urographic studies? | Intravenous Urography (IVU) Pyelography (old=IVP) Nephrotomography (before CT due to obliquity) Nephrourography-images after contrast injected into veins
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| Describe how a retrograde urograph is performed: | by introducing contrast against the normal flow via ureteral or urethral catheterization
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| Which study is an excretory technique? | The IVU--Intravenous Urography
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| What is demonstrated by a Pyelography study? | The renal pelvis & calyces
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| Why are lower contrast concentrations used in bladder studies? | Due to the large amount required to fill the bladder.
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| What type of contrast do we use to reduce adverse reactions? | NonIonic Iodinated Media
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| What are the 3 categories of adverse reactions to contrast? | Mild, moderate, & severe
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| List Mild adverse reactions to Contrast | Sensation of warmth, sneezing, flushing, metallic taste, a few hives
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| List Moderate adverse reactions to Contrast | Nausea, vomiting, itching, (edema of respiratory mucous membranes)
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| List Severe adverse reactions to Contrast | Respiratory Edema, Anaphylactic reactions, cardiac/respiratory crisis
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| What are 4 things we do to reduce chances of adverse reactions? | 1. Fully Assess prior to administering contrast. 2. check history carefully--include food/meds (all)allergies (shellfish), 3. Have crash cart, O2,& suction ready 4. Do Not leave Patient alone 1st 5 min.
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| What should be included in patient assessment before administering contrast? | 1. hx. of allergies 2. current meds 3. surgical procedures (for venipunture site) 4. Past/Current disease processes 5. Lab values for BUN & Creatinine
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| When should you verify IV Contrast? | 1. Before prep 2. During Prep 3. Before Admin (all)
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| Why should you inject air into the contrast vial prior to drawing? | Reduce air bubbles in the syringe
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| Since a bowel prep is not attempted on children/infants, what can be done to better visualize their urinary tracts? | Give them a carbonated beverage to distend stomach. Pushes intestinal loops inferiorly, allows upper irinary tracts to be better visualized.
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| Clear demonstration of the urinary tract requires what prep of the intestinal tract | The instestinal tract must be free of gas & fecal matter: low residue diet 1-2 days prior Lt. evening meal day prior non-gas laxative day before(as needed) NPO after midnight Need to be WELL HYDRATED (H2O)
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| What types of patients have a higher risk of contrast induced renal failure if dehydrated? | Diabetics, Multiple Myeloma High Uric Acid Levels
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| What is the normal BUN range & when is it contrainindicated? | 5-21 range over 65
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| What is the normal Creatinine range & when is it contrainindicated? | 0.6-1.0 range over 1.6
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| Is a full prep required for a lower urinary tract study? | No--just looking at the bladder
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| How much H20 should one drink a few hours prior to a retrograde exam? | 4-5 cups to decrease dehydration chances
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| Why is compression used in excretory urography (IVU)? | To retard the flow into the bladder ensuring the renal pelvis & calyces get filled
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| Where is Compression centered when used? | Over the level of the ASIS
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| What can be used in place of compression with somewhat same results/less risks? | 15 degree Trendelenburg
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| When is Ureteral Compression contrainindicated? | urinary stones abdominal masses aortic aneurysm colostomy suprapubic catheter traumatic injury
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