Ch 14 Urinary System and Venipuncture
1. The kidneys and ureters are located in the (intraperitoneal, infraperitoneal, extraperitonealm retroperitoneal)
Retroperitoneal
2. The ____ glands are located directly superior to the kidneys
Suprarenal (adrenal) glands
3. Which structures create a 20 degree angle between the upper pole and lower pole of the kidney
Psoas major muscles
4. What is the specific name for the mass of fat that surrounds each kidney
perirenal fat or adipose capsule
5. What degree or rotation from supine is required to place the kidneys parallel to the IR
30 degrees
6. Which two landmarks can be palpated to located the kidneys
xiphoid process and iliac crest
7. Which term describes an abnormal drop of the kidneys when the patient is placed erect
nephroptosis
8 Three functions of the urinary system
remove nitrogenous waste, regulate water levels, regulate acid-base balance
9. A buildup of nitrogenous waste in the blood is called
uriemia
10. The longitudinal fissure found along the central medial border of the kidney is called
hilum
11. The peripheral or outer portion of the kidney is called the
cortex
12. The term that describes the total functioning portion of the kidney is called.
renal parenchyma
13. The microscopic functional and structural unit of the kidney is
nephron
14. True or False: the efferent arterioles carry blood to the glomeruli
False
15. What is another (older) name for the glomerular capsule
bowman capsule
16. True or False: The glomerular capsule and proximal and distal convoluted tubules are located in the medulla of the kidney
False
17. Which structure of the medulla is made up of a collection of tubules that drain into the minor calyx
Renal pyramids
18. Which two processes move urine through the ureters to the bladder
peristalsis and gravity
19. Which structure is located most anterior as compared to the others listed (proximal ureters, kidneys, urinary bladder, suprarenal glands)
urinary bladder
20. What is the name of the junction found between the distal ureters and urinary bladder?
Ureterovesical junction
21. What is the name of inner, posterior region of the bladder formed by the two ureters entering and the urethra exiting?
Trigone
22. What is the name of the small gland found just inferior to the male bladder
prostate
23. The total capacity for the average adult bladder is
350 - 500 mL
24. Which of the following is considered most posterior (ovaries, urethra, vagina, kidneys)
Kidneys
25. Intravenous contrast media may be administered by either
bolus injection or drip infusion
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. For most IVUs, veins in the ____ are recommended for venipuncture
antecubital fossa
28. The most common size of needle used for bolus injections on a adult is
18 to 22 gauge
29. The two most common types of needles used for bolus injection of contrast media are
butterfly and over-the-needle catheter
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. True or False: The bevel of the needle needs to be facing downward during the actual puncture into a vein.
False
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. True or False: If unsuccessful during the initial puncture, a new needle should be used during the second attempt.
True
34. True or False: The radiologist is responsible for documenting all aspects of the venipuncture procedure in the patient's chart.
False
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. 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. 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. 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. 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.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. 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. 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
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
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
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
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
45. An expected outcome to the introduction of contrast media is described as a
side effect
46. The normal creatine level for an adult should range between
0.6 - 1.5mg/dL
47. Normal BUN levels for an adult should range between
8-25 mg/100 mL
48. Metformin hydrochloride is a drug that is taken for the management of
diabetes mellitus
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
50. The leakage of contrast media from a vessel into the surrounding soft tissues is called
extravasation (inflatration)
51. List two general categories of contrast media reactions
local and systemic
52. Which type of reaction is a true allergic response to iodinated contrast media
anaphylactic reaction
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
54. True or False: Vasovagal reactions are not considered to be life threating
False
55. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe
Bradycardia (<50 beats/minute)
Severe
56. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe
Tachycardia (>100 beats/minute)
Moderate
57.Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe
Angioedema
Moderate
58. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe
Lightheadedness
Mild
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
60. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe
Temporary renal faliure
Severe
61. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe
Laryngeal swelling
Severe
62. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe
Cardiac arrest
Severe
63. Match the following symptom to the correct category of systemic contrast media reaction: Mild, Moderate, Severe
Mild hives
Mild
64. True or False: Mild-level contrast media reactions do not usually require medication or medical assistance
True
65. True or False: Uritcaria is the formal term for excessive vomiting
False
66. A temporary failure of the renal system is an example of (mild, moderate, severe, local) reaction
Severe
67. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local
Convulsion
Severe systemic
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
69. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local
Angioedema
Moderate systemic
70. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local
Bradycardia
Severe systemic
71. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local
Itching
Mild systemic
72. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local
Vomiting
Mild systemic
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
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
75. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local
Pulmonary edema
local
76. Match the following symptom to the type of contrast media reaction: Side effect, Mild systemic, Moderate systemic, Severe systemic, Local
Extravasatation
severe systemic
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
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
79. What is the primary purpose of the premedication procedure before an iodinated contrast media procedure?
To reduce the severity of contrast media reactions
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
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
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
83. True or False: Tissue inflammation from extravasated contrast media peaks 1 to 2 hours after the incident.
False
84. True or False: Acute renal failure may occur 48 hours after an iodinated contrast media procedure.
True
85. A trademark name for a diuretic drug is
Lasix
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
87. What is the correct term and correct abbreviation for IVP
Intravenous urogram (IVU)
88. Which specific aspect of the kidney is visualized during an IVU
The collecting system of the kidney
89. Which one of the following conditions is a common pathologic indication of an IVU (Sickle cell anemia, multiple myeloma, hematuria, anuria)
Hematuria
90. Which one of the following conditions is described as a rare tumor of the kidney (pheochromocytoma, multiple myeloma, melanoma, renal cell carcinoma)
pheochromocytoma
91. Pneumouria is a urinary pathological term that means
presence of gas in urine
92. Urinary reflux is a urinary pathological term that means
backward return flow of urine
93. Uremia is a urinary pathological term that means
excess urea and creatinine in the blood
94. Anuria is a urinary pathological term that means
complete cessation of urinary secretion
95. Polyuria is a urinary pathological term that means
passage of large volume of urine
96. Micturition is a urinary pathological term that means
act of voiding
97. Retention is a urinary pathological term that means
Inability to void
98. Oliguria is a urinary pathological term that means
diminished amount of urine being excreted
99. Glucosuria is a urinary pathological term that means
presence of glucose in urine
100. Urinary incontinence is a urinary pathological term that means
constant or frequent involuntary passage of urine
101. Renal agenesis is a urinary pathological term that means
absence of a functioning kidney
102. Acute renal failure is a urinary pathological term that is indicated by
Indicated by presence of uremia, oliguria, or anuria
103. Pathological disorder Vesicorectal fistula is
artificial opening between the urinary bladder and aspects of the large intestine
104. Pathological disorder Renal hypertension is
increased blood pressure to the kidneys due to atherosclerosis
105. Pathological disorder Ectopic kidney is
Normal kidney that fails to ascend into the abdomen but remains in the pelvis
106. Pathological disorder Horseshoe kidney is
Fusion of the lower poles of kidneys during the development of the fetus
107. Pathological disorder staghorn calculus is
A large stone that grows and completely fill the renal pelvis
108. Pathological disorder polycystic kidney disorder is
multiple cysts in one or both kidneys
109. Pathological disorder Benign prostatic hyperplasia is
enlargement of the prostate gland
110. Pathological disorder Glomerulonephritis is
inflammation of the capillary loops of the golmeruli of the kidneys
111. Malrotation has the radiographic appearance of:
abnormal rotation of the kidney
112. Vesicorectal fistula has the radiographic appearance of:
signs of abnormal fluid collections
113. Renal cell carcinoma has the radiographic appearance of:
Irregular appearance of renal parenchyma or collecting system
114. BPH has the radiographic appearance of:
Elevated or indented floor of bladder
115. Renal hypertension has the radiographic appearance of:
rapid excretion of contrast media
116. Renal calculi has the radiographic appearance of:
signs of obstruction of urinary system
117. Cystitis has the radiographic appearance of:
Mucosal changes within the bladder
118. Chronic Bright disease has the radiographic appearance of:
Bilateral, small kidneys with blunted calyces
119. A condition characterized by regions or areas of subcutaneous swelling caused by allergic reaction to food or drugs is termed
Angioedema
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
121. Loss of consciousness resulting from reduced cerebral blood flow is termed
syncope
122. An eruption of wheals (hives) is often caused by a hypersensitivity to food or drugs is a condition termed
urticaria
123. What type of calculi is often associated with chronic tract infections
staghorn calculi
124. True or False: The patient should void before an IVU to prevent possible rupture of the bladder if compression is applied
True
127. What is the primary purpose of ureteric compression
128. When does the timing for an IVU exam start
129. What is the primary difference between a standard and a hypertensive IVU
130. In which department are most retrograde urograms performed
131. True or False: A retrograde urogram examines the anatomy and function of the pelvicaliceal system.
132. True or False: the brodney clamp is used for male and female retrograde cystourethrograms
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. Which of the following alternative imaging modalities is not routinely being used to diagnose renal calculi (Nuclear medicine, sonography, MRI, CT)
135. True or False: Urinary studies on pediatric patients should be scheduled early in the morning to minimize the risk for dehydration