Chapter 14: Urinary System and Venipuncture

An exam of the kidneys, ureters, and bladder. This exam is preformed in radiology and includes a series of abdominal radiographs following the injection of an iodinated contrast medium. This exam can show signs of obstruction, hydronephrosis, tumor, or infection

Intravenous Urogram (IVU)

A brand name for a diuretic

Lasix

Which drug is often given before an IVU to reduce the risk of a contrast media reaction?

benadryl and prednisone

What is the recommended treatment protocol for extravasation?

elevate the limb and apply cold compress

What is the recommended exam for a patient in the ER with suspected kidney stones?

CT or KUB

What should you do if a patient develops an allergic reaction after receiving contrast media?

Call nurse/ crash cart- code team if patient is unresponsive

The normal creatinine level (diagnostic indication of kidney function) for an adult is:

0.6 to 1.5 mg/dL

Normal BUN levels in adults should not exceed __ mg per 100 ml.

25mg / 100ml

The average adult kidney measures ___ in length.

4 to 5 inches

What are the contraindication for using compression?

Abdominal sugery, trama pain, abdominal mass

What veins should be used for venipuncture?

Basilic, cephalic, median cubital

What are stones called that form in the bladder?

Bladder calculi

What is a tumor that is three times more common in males than in females?

Bladder carcinoma

Contraction of the bronchi and bronchiolar muscles, producing restriction of air passages

Brochospasm

What is the congenital anomaly that involves two ureters and/or he renal pelvis originating from the same kidney?

Duplication of the ureter and renal pelvis

What is the congenital anomaly that involves a normal kidney that fails to ascend into the abdomen but remains in the pelvis?

Ectopic Kidney

T/F: If both procedures are ordered on the same day, a BE must be performed before an IVU.

False

An inflammation of the capillary loops of the glomeruli of the kidneys

Glomerulonephritis

This is a distention of the renal pelvis and calyces of the kidneys that results from some obstruction of the ureters or renal pelvis

Hydronephrosis

This exam is performed on patient with high blood pressure to determine whether the kidneys are the causes of the hypertension

Hypertensive intravenous urogram

The act of voiding or urination is also called?

Micturition

A single AP radiograph of the kidney region taken within 60 seconds following injection; centered midway between the xiphoid process and the iliac crest

Nephrogram

The basic structural and functional unit of the kidney is the:

Nephron

What is the abnormal drop in the position of the kidneys when the patient is erect?

Nephroptosis

This disease is the most common cause of enlarged kidneys and is characterized by cysts scattered throughout one or both kidneys

Polycystic Kidney Disease

What is the primary function of the urinary system?

Production of urine and its elimination

What are some reasons for doing an erect image during an IVU?

Prostate Problems, Nephroptosis, BPH

What is the second most common malignancy in males over the age of 50 called? It is a slow growing tumor and may not be detected for years.

Prostate carcinoma

The presence of excessive serum protein levels in the urine is called?

Proteinuria

These are all contraindications for what? Diabetes, severe renal disease, patients taking metformin, renal failure, sickle cell anemia, pheochromocytoma, multiple myeloma, CHR, anuria

Receiving Iodinated contrast

What is the primary purpose of the premedication procedure before an iodinated contrast media study?

Reduces the severity of possible contrast media reaction

This is when blood pressure increases to the kidney through the renal artery due to atherosclerosis. *This often requires an alternation of the normal IVU routine and sonography is the preferred exam.

Renal Hypertension

The absence of formation of a kidney is called what?

Renal agenesis

The most frequent type of malignant tumor of the kidney, it is three times more common in males than females; and an irregular appearance of parenchyma or collecting system may be visualized radiographically

Renal cell carcinoma

This can be caused by necrotic debris, calculus, thrombus, or trauma; and can lead to renal damage.

Renal obstruction

This is a nonfunctional exam of the urinary system where contrast medium is introduced directly retrograde (backwards against the flow) via catherization

Retrograde Urogram

What is a large stone that grows and fills the renal pelvis completely, blocking the flow of urine, called?

Staghorn calculus

What is the purpose of applying a cold compress and elevating the limb following a contrast injection?

To treat extravasation

How long should you leave the needle in for the IVU procedure? ***T/F-The technologist should leave a butterfly needle in the vein for the first part of the IVU following injection.***

True

T/F: The bevel of the needle should face upward during venipuncture

True

What are the three constricted points along each ureter?

UPJ UVJ Near the brim of pelvi

An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acid metabolism; often present with chronic renal failure

Uremia

The backward or return flow of urine from the bladder into the ureter and kidney is called?

Urinary reflux/ vesicoureteral reflux

A fistual that forms between the urinary bladder and rectum or aspects of the colon. This can be caused by trauma, tumor, or congenital defect. Cystography can be performed, or a barium enema; but the CT is preferred

Vesicorectal (vesicocolonic fistula

Similar to cystography, this exam includes radiographs taken while the patient is voiding and is considered to be a functional study of the bladder and urethra

Voiding cystourethrogram

A radiograph of an LPO position taken during an IVU reveals that the right kidney is foreshortened and superimposed over the spine. What must the technologist do to correct this error during the repeat exposure?

decrease rotation

This is the inflammation of the kidney and renal pelvis that is causes by pyogenic bacteria

pyelonephritis

There are all contraindications for what? Possible uretheric stones, abdominal mass, recent abdominal pain, acute abdominal trauma

receiving ureteric compression

The inability of a kidney to excrete metabolites at normal plasma levels, or the inability to retain electrolytes under conditions of normal intake

renal failure

An exam performed on males only, it is done to show trauma or obstruction of the urethra

retrograde Urethrogram

This is a nonfunctional exam of the urinary bladder that is performed after iodinated contrast medium is injected via urethral catheter. This is a common exam to rule out trauma, calculi, tumor, and inflammatory diseases

retrograde cystogram

One of the three constricted points along each ureter is the pelvic brim. The location of this constricted point is:

where the iliac blood vessels cross over the ureters