Bontrager Chapter 14 Workbook
The normal creatinine level for an adult should range between ___________ & ___________
0.6 & 1.5 mg/dL
In the correct order, list the 6 steps followed during a venipuncture procedures as listed & described in the textbook
1. Wash hands & put on gloves 2. Select site, apply tourniquet, & cleanse the site 3. Initiate puncture 4. Confirm entry & secure needle 5. Prepare & proceed with injection 6. Remove needle or catheter
What degree of rotation from supine is required to place the kidneys parallel to the IR?
30 degrees
Normal BUN levels for an adult should range between _______ & _______.
8 & 25 mg/100 mL
Intravenous contrast media may be administered either by
A. Bolus injection B. Drip infusion
A. Metformin hydrochloride is a drug that is taken for the management of _________. B. The American College of Radiology recommends that metformin be withheld for ________ hours after a contrast medium procedure in patients with known acute renal injury, stage IV or V renal disease, or an estimated glomerular filtration rate of <30 & resumed only if kidney function is again determined to be within normal limits.
A. Diabetes mellitus B. 48 hours
Which of the following compounds is a common anion found in ionic contrast media? A. Diatrizoate or iothalamate B. Sodium or meglumine C. Benzoic acid D. None of the above
A. Diatrizoate or iothalamate
List 10 contraindications that may prevent a patient from having a contrast media procedure performed
A. Hypersensitivity to iodinated contrast media B. Anuria C. Multiple myeloma D. Diabetes mellitus E. Severe hepatic or renal disease F. Congestive heart failure G. Pheochromocytoma H. Sickle cell anemia I. Patients taking metformin or similar medication J. Renal failure, acute or chronic
A. Why is the term IVP incorrect when describing a radiographic examination of the kidneys, ureters, & bladder after the intravenous injection of contrast media? B. What is the correct term & abbreviation for IVP?
A. IVP (intravenous pyelogram) is a study of the renal pelvis (hence, pyelo-) B. Intravenous Urogram (IVU)
List the 2 general categories of contrast media reactions
A. Local B. Systemic
Which 2 processed move urine through the ureters to the bladder?
A. Peristalsis B. Gravity
Which of the following conditions is described as a rare tumor of the adrenal gland? A. Pheochromocytoma B. Multiple myeloma C. Melanoma D. Renal cell carcinoma
A. Pheochromocytoma
List the 3 functions of the kidneys
A. Removes nitrogenous wastes B. Regulates water levels in body C. regulate acid-base balance & electrolyte levels of blood
Which type of reaction is a true allergic response to iodinated contrast media?
Anaphylactic reaction
Which type of patient is a likely candidate for the premedication procedure before a contrast media study? A. Elderly patient B. Asthmatic patient C. Pediatric patient D. Patient with hypertension
B. Asthmatic patient
A buildup of nitrogenous waste in the blood is called: A. Hemotoxicity B. Uremia C. Sepsis D. Renotoxicity
B. Uremia
What is another (older) name for the glomerular capsule?
Bowman capsule
The two most common types of needles used for bolus injection of contrast media are __________ & __________.
Butterfly & over-the-needle catheter
The most common size of needle used for bolus injections on adults is: A. 23 to 25 gauge B. 14 to 16 gauge C. 18 to 22 gauge D. 28 gauge
C. 18 to 22 gauge
A total capacity for the average adult bladder is: A. 100-200 mL B. 200-300 mL C. 350-500 mL D. 500-700 mL
C. 350-500 mL
Which of the following drugs is often given to the patient as part of the premedication procedure? A. Epinephrine B. Valium C. Combination of Benadryl & prednisone D. Lasix
C. Combination of Benadryl & prednisone
Which of the following conditions is a common pathologic indication for an IVU? A. Sickle cell anemia B. Multiple myeloma C. Hematuria D. Anuria
C. Hematuria
A temporary failure of the renal system is an example of a(n) ________ reaction. A. Mild B. Moderate C. Severe D. Local
C. Severe
Which of the following structures is located most anterior as compared with the others? A. Proximal ureters B. Kidneys C. Urinary bladder D. Suprarenal glands
C. Urinary bladder
What should the technologist do first when a patient is experiencing either a moderate- or a severe-level contrast media reaction?
Call for medical assistance
For most IVUs, veins in the ________ are recommended for venipuncture. A. Iliac fossa B. Anterior, carpal region C. Axillary fossa D. Antecubital fossa
D. Antecubital fossa
Any disruption in the physiologic functions of the body that may lead to a contrast media reaction is the basis for the: A. Homeostasis theory B. Anaphylactoid theory C. Vasovagal theory D. Chemotoxic theory
D. Chemotoxic theory
Which of the following structures is considered most posterior? A. Ovaries B. Urethra C. Vagina D. Kindneys
D. Kidneys
The kidneys & ureters are located in the ________ space. A. Intraperitoneal B. Infraperitoneal C. Extraperitoneal D. Retroperitoneal
D. Retroperitoneal
In addition to notifying a nurse or physician when contrast media have extravasated into the soft tissues, what should the technologist first do to increase reabsorption?
Elevate the affected extremity or use a cold compress followed by a warm compress
The leakage of contrast media from a vessel into the surrounding soft tissues is called
Extravasation (infiltration)
True/False: Vasovagal reactions are not considered to be life threatening
False
True/False: The radiologist is responsible for documenting all aspects of the venipuncture procedure in the patient's chart
False (The technologist or person performing the venipuncture is responsible)
True/False: The efferent arterioles carry blood to the glomeruli
False (afferent)
True/False: The bevel of the needle must face downward during the actual puncture into a vein
False (facing upward)
True/False: The glomerular capsule & proximal & distal convoluted tubules are located in the medulla of the kidney
False (located in the cortex)
True/False: If extravasation occurs during the puncture, the technologist should slightly retract the needle & then push it forward again.
False (the needle should be withdrawn & pressure applied)
True/False: Urticaria is the formal term for excessive vomiting
False (the term for hives)
True/False: Tissue inflammation from extravasated contrast media peaks 1 to 2 hours after the incident.
False - peaks 24 to 48 hours after extravasation
Indicate whether this characteristic applies to ionic (I) or nonionic (N) contrast media: Creates a hypertonic condition in the blood plasma
I
Indicate whether this characteristic applies to ionic (I) or nonionic (N) contrast media: Incorporates sodium or meglumine to increase solubility of the contrast media
I
Indicate whether this characteristic applies to ionic (I) or nonionic (N) contrast media: May increase the severity of side effects
I
Indicate whether this characteristic applies to ionic (I) or nonionic (N) contrast media: Poses a greater risk for disrupting homeostasis
I
Indicate whether this characteristic applies to ionic (I) or nonionic (N) contrast media: Uses a parent compound of benzoic acid
I
A trademark name for a diuretic drug is
Lasix
For the symptom, identify the type of contrast media reaction: Extravasation
Local
Mild, Moderate, or Severe: Lightheadedness
Mild
Mild, Moderate, or Severe: Mild hives
Mild
For the symptom, identify the type of contrast media reaction: Itching
Mild systemic
For the symptom, identify the type of contrast media reaction: Vomiting
Mild systemic
Mild, Moderate, or Severe: Angioedema
Moderate
Mild, Moderate, or Severe: Tachycardia (>100 beats/min)
Moderate
For the symptom, identify the type of contrast media reaction: Angioedema
Moderate systemic
For the symptom, identify the type of contrast media reaction: Severe urticaria
Moderate systemic
Indicate whether this characteristic applies to ionic (I) or nonionic (N) contrast media: Is a near-isotonic solution
N
Indicate whether this characteristic applies to ionic (I) or nonionic (N) contrast media: Is more expensive
N
Indicate whether this characteristic applies to ionic (I) or nonionic (N) contrast media: Produces less sever reactions
N
Indicate whether this characteristic applies to ionic (I) or nonionic (N) contrast media: Uses a parent compound of an amide or glucose group
N
Indicate whether this characteristic applies to ionic (I) or nonionic (N) contrast media: Will not significantly increase the osmolality of the blood plasma
N
Which term describes an abnormal drop of the kidneys when the patient is placed erect?
Nephroptosis
Which structures create a 20-degree angle between the upper pole & the lower pole of the kidney?
Psoas major muscles
Mild, Moderate, or Severe: Brachycardia (<50 beats/min)
Severe
Mild, Moderate, or Severe: Cardiac arrest
Severe
Mild, Moderate, or Severe: Hypotension (systolic blood pressure <80 mm Hg)
Severe
Mild, Moderate, or Severe: Laryngeal swelling
Severe
Mild, Moderate, or Severe: Temporary renal failure
Severe
For the symptom, identify the type of contrast media reaction: Bradycardia
Severe systemic
For the symptom, identify the type of contrast media reaction: Convulsions
Severe systemic
For the symptom, identify the type of contrast media reaction: Pulmonary edema
Severe systemic
For the symptom, identify the type of contrast media reaction: Respiratory arrest
Severe systemic
An unexpected outcome to the introduction of contrast media is described as a
Side effect
For the symptom, identify the type of contrast media reaction: Metallic taste
Side effect
For the symptom, identify the type of contrast media reaction: Temporary hot flash
Side effect
Which specific aspect of the kidney is visualized during an IVU?
The collecting system of the kidney (Minor & major calyces, renal pelvis, & proximal ureters)
What is the primary purpose of the premedication procedure before an iodinated contrast media procedure?
To reduce the severity of contrast media reactions
True/False: Acute renal failure may occur 48 hours after an iodinated contrast media procedure
True
True/False: If unsuccessful during the initial puncture, a new needle should be used during the second attempt.
True
True/False: Mild-level contrast media reactions do not usually require medication or medical assistance
True
True/False: The patient (or legal guardian) must sign an informed consent form before a venipuncture procedure is performed on a pediatric patient
True
What is the name of the junction found between the distal ureters & the urinary bladder?
Ureterovesical (UV) Junction
Which type of reaction is caused by the stimulation of the vagus nerve by the introduction of a contrast medium, which causes heart rate & blood pressure to fall?
Vasovagal reaction
Which 2 landmarks can be palpated to locate the kidneys?
Xiphoid process & Iliac crest
What is the specific name for the mass of fat that surrounds each kidney?
adipose capsule or perirenal fat
Located in the medulla or cortex: Afferent arteriole
cortex
Located in the medulla or cortex: Distal convoluted tubule
cortex
Located in the medulla or cortex: Efferent arteriole
cortex
Located in the medulla or cortex: Glomerular capsule
cortex
Located in the medulla or cortex: Proximal convoluted tubule
cortex
The peripheral or outer portion of the kidney is called the
cortex
The longitudinal fissure found along the central medial border of the kidney is called the
hilum
Located in the medulla or cortex: Ascending limb
medulla
Located in the medulla or cortex: Collecting tubule
medulla
Located in the medulla or cortex: Descending limb
medulla
Located in the medulla or cortex: Loop of Henle
medulla
The microscopic functional & structural unit of the kidney is the
nephron
What is the name of the small gland found just inferior to the male bladder?
prostate gland
The term that describes the total functioning portion of the kidney is
renal parenchyma
Which structure of the medulla is made up of a collection of tubules that drain into the minor calyx?
renal pyramids
The ____________ glands are located directly superior to the kidneys
suprarenal (adrenal) glands
What is the name of the inner, posterior region of the bladder formed by the 2 ureters entering & the urethra exiting?
trigone
