Ch 14 Urinary System and Venipuncture

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1

1. The kidneys and ureters are located in the (intraperitoneal, infraperitoneal, extraperitonealm retroperitoneal)

Retroperitoneal

2

2. The ____ glands are located directly superior to the kidneys

Suprarenal (adrenal) glands

3

3. Which structures create a 20 degree angle between the upper pole and lower pole of the kidney

Psoas major muscles

4

4. What is the specific name for the mass of fat that surrounds each kidney

perirenal fat or adipose capsule

5

5. What degree or rotation from supine is required to place the kidneys parallel to the IR

30 degrees

6

6. Which two landmarks can be palpated to located the kidneys

xiphoid process and iliac crest

7

7. Which term describes an abnormal drop of the kidneys when the patient is placed erect

nephroptosis

8

8 Three functions of the urinary system

remove nitrogenous waste, regulate water levels, regulate acid-base balance

9

9. A buildup of nitrogenous waste in the blood is called

uriemia

10

10. The longitudinal fissure found along the central medial border of the kidney is called

hilum

11

11. The peripheral or outer portion of the kidney is called the

cortex

12

12. The term that describes the total functioning portion of the kidney is called.

renal parenchyma

13

13. The microscopic functional and structural unit of the kidney is

nephron

14

14. True or False: the efferent arterioles carry blood to the glomeruli

False

15

15. What is another (older) name for the glomerular capsule

bowman capsule

16

16. True or False: The glomerular capsule and proximal and distal convoluted tubules are located in the medulla of the kidney

False

17

17. Which structure of the medulla is made up of a collection of tubules that drain into the minor calyx

Renal pyramids

18

18. Which two processes move urine through the ureters to the bladder

peristalsis and gravity

19

19. Which structure is located most anterior as compared to the others listed (proximal ureters, kidneys, urinary bladder, suprarenal glands)

urinary bladder

20

20. What is the name of the junction found between the distal ureters and urinary bladder?

Ureterovesical junction

21

21. What is the name of inner, posterior region of the bladder formed by the two ureters entering and the urethra exiting?

Trigone

22

22. What is the name of the small gland found just inferior to the male bladder

prostate

23

23. The total capacity for the average adult bladder is

350 - 500 mL

24

24. Which of the following is considered most posterior (ovaries, urethra, vagina, kidneys)

Kidneys

25

25. Intravenous contrast media may be administered by either

bolus injection or drip infusion

26

26. True or False: The patient (or guardian) must sign an informed consent form before a venipuncture procedure is performed on a pediatric patient.

True

27

27. For most IVUs, veins in the ____ are recommended for venipuncture

antecubital fossa

28

28. The most common size of needle used for bolus injections on a adult is

18 to 22 gauge

29

29. The two most common types of needles used for bolus injection of contrast media are

butterfly and over-the-needle catheter

30

30. List the six steps followed during a venipuncture procedure as listed and described in the book.

wash hands and put on gloves, select site, apply tourniquet , and clean site. Initiate puncture. Confirm entry and secure needle. Prepare and proceed with injection. Remove needle or catheter.

31

31. True or False: The bevel of the needle needs to be facing downward during the actual puncture into a vein.

False

32

32. True or False: If extravasation occurs during the puncture, the technologist should slightly retract the needle and then push it forward again.

False

33

33. True or False: If unsuccessful during the initial puncture, a new needle should be used during the second attempt.

True

34

34. True or False: The radiologist is responsible for documenting all aspects of the venipuncture procedure in the patient's chart.

False

35

35. The two major types of iodinated contrast media used for urography are ionic and nonionic. Indicated whether the following characteristics applies to Ionic or Nonionic:

Uses a parent compound of a benzoic acid

Ionic

36

36. The two major types of iodinated contrast media used for urography are ionic and nonionic. Indicated whether the following characteristics applies to Ionic or Nonionic:

Will not significantly increase the osmolarity of the blood plasma

Nonionic

37

37. The two major types of iodinated contrast media used for urography are ionic and nonionic. Indicated whether the following characteristics applies to Ionic or Nonionic:

Incorporates sodium or meglumine to increase solubility of the contrast media

Ionic

38

38. The two major types of iodinated contrast media used for urography are ionic and nonionic. Indicated whether the following characteristics applies to Ionic or Nonionic:

Creates a hypertonic condition in the blood plasma

Ionic

39

39. The two major types of iodinated contrast media used for urography are ionic and nonionic. Indicated whether the following characteristics applies to Ionic or Nonionic:

Is more expensive

Nonionic

40

40.The two major types of iodinated contrast media used for urography are ionic and nonionic. Indicated whether the following characteristics applies to Ionic or Nonionic:

Produces a less sever reactions

Nonionic

41

41. The two major types of iodinated contrast media used for urography are ionic and nonionic. Indicated whether the following characteristics applies to Ionic or Nonionic:

Poses a greater risk for disrupting homeostasis

Ionic

42

42. The two major types of iodinated contrast media used for urography are ionic and nonionic. Indicated whether the following characteristics applies to Ionic or Nonionic:

Is a near-isotonic solution

Nonionic

43

41. The two major types of iodinated contrast media used for urography are ionic and nonionic. Indicated whether the following characteristics applies to Ionic or Nonionic:

Uses a parent compound of an amide or glucose group

Nonionic

44

42. The two major types of iodinated contrast media used for urography are ionic and nonionic. Indicated whether the following characteristics applies to Ionic or Nonionic:

May increase the severity of side effects

Ionic

45

43. Which one of the following compounds is a common anion found in ionic contrast media (diatrizoate or iothalamate, sodium or meglumine, benzoic acid, none of the above)

Diatrizoate or iothalamate

46

44. Any disruption in the physiologic functions of the body that may lead to a contrast media reaction is the basis for the: (homeostasis theory, Anaphylactoid theory, Vasovagal theory, Chemotoxic theory)

chemotoxic theroy

47

45. An expected outcome to the introduction of contrast media is described as a

side effect

48

46. The normal creatine level for an adult should range between

0.6 - 1.5mg/dL

49

47. Normal BUN levels for an adult should range between

8-25 mg/100 mL

50

48. Metformin hydrochloride is a drug that is taken for the management of

diabetes mellitus

51

49. American college of radiology recommends that metformin be withheld for _____ hours after a contrast medium procedure and resumed only if kidney function is again determined within normal limits

48

52

50. The leakage of contrast media from a vessel into the surrounding soft tissues is called

extravasation (inflatration)

53

51. List two general categories of contrast media reactions

local and systemic

54

52. Which type of reaction is a true allergic response to iodinated contrast media

anaphylactic reaction

55

53. Which type of reaction is caused by stimulation of the vagus nerve by introduction of a contrast medium, which causes heart rate and blood pressure to fall

Vasovagal reaction

56

54. True or False: Vasovagal reactions are not considered to be life threating

False

57

55. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe

Bradycardia (<50 beats/minute)

Severe

58

56. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe

Tachycardia (>100 beats/minute)

Moderate

59

57.Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe

Angioedema

Moderate

60

58. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe

Lightheadedness

Mild

61

59. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe

Hypotension (systolic blood pressure <80 mm Hg)

Severe

62

60. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe

Temporary renal faliure

Severe

63

61. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe

Laryngeal swelling

Severe

64

62. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe

Cardiac arrest

Severe

65

63. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe

Mild hives

Mild

66

64. True or False: Mild-level contrast media reactions do not usually require medication or medical assistance

True

67

65. True or False: Uritcaria is the formal term for excessive vomiting

False

68

66. A temporary failure of the renal system is an example of (mild, moderate, severe, local) reaction

Severe

69

67. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local

Convulsion

Severe systemic

70

68. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local

Metalic taste

Side effect

71

69. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local

Angioedema

Moderate systemic

72

70. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local

Bradycardia

Severe systemic

73

71. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local

Itching

Mild systemic

74

72. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local

Vomiting

Mild systemic

75

73. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local

Temporary hot flash

side effect

76

74. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local

Respiratory arrest

Sever systemic

77

75. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local

Pulmonary edema

local

78

76. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local

Extravasatation

severe systemic

79

77. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local

Severe urticaria

Moderate systemic

80

78. What should the technologist do first when a patient is experiencing either a moderate or severe level contrast media reaction

Call for medical assistance

81

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

To reduce the severity of contrast media reactions

82

80. Which of the following drugs is often given to the patient as part of the premedication procedure (epinephrien, valium, combination of Benedryl and prednisone, lasix)

Combination of benedryl and prednisone

83

81. Which type of patient is likely candidate for the premedication procedure before a contrast media study (elderly patient, asthmatic patient, pediatric patient, patient with hypertension)

Asthmatic patient

84

82. In addition to notifying a nurse or physician when contrast media has 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

85

83. True or False: Tissue inflammation from extravasated contrast media peaks 1 to 2 hours after the incident.

False

86

84. True or False: Acute renal failure may occur 48 hours after an iodinated contrast media procedure.

True

87

85. A trademark name for a diuretic drug is

Lasix

88

86. Why is the term IVP incorrect in describing a radiographic examination of the kidney's ureters, and bladder after intravenous injection of contrast media

IVP is a study of the renal pelvis

89

87. What is the correct term and correct abbreviation for IVP

Intravenous urogram (IVU)

90

88. Which specific aspect of the kidney is visualized during an IVU

The collecting system of the kidney

91

89. Which one of the following conditions is a common pathologic indication of an IVU (Sickle cell anemia, multiple myeloma, hematuria, anuria)

Hematuria

92

90. Which one of the following conditions is described as a rare tumor of the kidney (pheochromocytoma, multiple myeloma, melanoma, renal cell carcinoma)

pheochromocytoma

93

91. Pneumouria is a urinary pathological term that means

presence of gas in urine

94

92. Urinary reflux is a urinary pathological term that means

backward return flow of urine

95

93. Uremia is a urinary pathological term that means

excess urea and creatinine in the blood

96

94. Anuria is a urinary pathological term that means

complete cessation of urinary secretion

97

95. Polyuria is a urinary pathological term that means

passage of large volume of urine

98

96. Micturition is a urinary pathological term that means

act of voiding

99

97. Retention is a urinary pathological term that means

Inability to void

100

98. Oliguria is a urinary pathological term that means

diminished amount of urine being excreted

101

99. Glucosuria is a urinary pathological term that means

presence of glucose in urine

102

100. Urinary incontinence is a urinary pathological term that means

constant or frequent involuntary passage of urine

103

101. Renal agenesis is a urinary pathological term that means

absence of a functioning kidney

104

102. Acute renal failure is a urinary pathological term that is indicated by

Indicated by presence of uremia, oliguria, or anuria

105

103. Pathological disorder Vesicorectal fistula is

artificial opening between the urinary bladder and aspects of the large intestine

106

104. Pathological disorder Renal hypertension is

increased blood pressure to the kidneys due to atherosclerosis

107

105. Pathological disorder Ectopic kidney is

Normal kidney that fails to ascend into the abdomen but remains in the pelvis

108

106. Pathological disorder Horseshoe kidney is

Fusion of the lower poles of kidneys during the development of the fetus

109

107. Pathological disorder staghorn calculus is

A large stone that grows and completely fill the renal pelvis

110

108. Pathological disorder polycystic kidney disorder is

multiple cysts in one or both kidneys

111

109. Pathological disorder Benign prostatic hyperplasia is

enlargement of the prostate gland

112

110. Pathological disorder Glomerulonephritis is

inflammation of the capillary loops of the golmeruli of the kidneys

113

111. Malrotation has the radiographic appearance of:

abnormal rotation of the kidney

114

112. Vesicorectal fistula has the radiographic appearance of:

signs of abnormal fluid collections

115

113. Renal cell carcinoma has the radiographic appearance of:

Irregular appearance of renal parenchyma or collecting system

116

114. BPH has the radiographic appearance of:

Elevated or indented floor of bladder

117

115. Renal hypertension has the radiographic appearance of:

rapid excretion of contrast media

118

116. Renal calculi has the radiographic appearance of:

signs of obstruction of urinary system

119

117. Cystitis has the radiographic appearance of:

Mucosal changes within the bladder

120

118. Chronic Bright disease has the radiographic appearance of:

Bilateral, small kidneys with blunted calyces

121

119. A condition characterized by regions or areas of subcutaneous swelling caused by allergic reaction to food or drugs is termed

Angioedema

122

120. Contraction of the muscle within the walls of the bronchi and bronchioles, producing a restriction of air passing through them, is a condition called

bronchospasm

123

121. Loss of consciousness resulting from reduced cerebral blood flow is termed

syncope

124

122. An eruption of wheals (hives) is often caused by a hypersensitivity to food or drugs is a condition termed

urticaria

125

123. What type of calculi is often associated with chronic tract infections

staghorn calculi

126

124. True or False: The patient should void before an IVU to prevent possible rupture of the bladder if compression is applied

True

127

127. What is the primary purpose of ureteric compression

...

128

128. When does the timing for an IVU exam start

...

129

129. What is the primary difference between a standard and a hypertensive IVU

...

130

130. In which department are most retrograde urograms performed

...

131

131. True or False: A retrograde urogram examines the anatomy and function of the pelvicaliceal system.

...

132

132. True or False: the brodney clamp is used for male and female retrograde cystourethrograms

...

133

133. Which of the following involves a direct introduction of the contrast media into the structural being studied (retrograde urogram, retrograde cystogram, retrograde urethrogram, All of the above)

...

134

134. Which of the following alternative imaging modalities is not routinely being used to diagnose renal calculi (Nuclear medicine, sonography, MRI, CT)

...

135

135. True or False: Urinary studies on pediatric patients should be scheduled early in the morning to minimize the risk for dehydration

...