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Ch 14 Urinary System and Venipuncture

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

no data
128.

128. When does the timing for an IVU exam start

no data
129.

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

no data
130.

130. In which department are most retrograde urograms performed

no data
131.

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

no data
132.

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

no data
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)

no data
134.

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

no data
135.

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

no data