Exam 28: Interventional Radiology

Some of the new complex interventional procedures may require prolonged fluoroscopic guidance in order to perform and complete the procedure.Select the procedure that requires prolonged fluoroscopic guidance.

A variety of specialty items are used for IR procedures.A Seldinger needle (18 gauge,2 3/4 inches)is commonly used for groin access.A sheath is commonly inserted at the arterial or venous puncture site.What is the function of the sheath?

Personnel radiation monitoring is an important part of radiation exposure safety.Select the statement that best describes the proper placement of the personal radiation dosimeter.

Embolic materials induce mechanical obstruction within a vessel and formation of thrombus via platelet activation and activation of the patient's clotting mechanism.Select an appropriate clinical indication for an embolic procedure.

The majority of serious reactions to contrast media occur immediately or within 20 minutes after the injection.Increased capillary permeability and constriction of bronchial smooth muscle cells are present.What statement by the patient would alert you to the possibility that the patient was having a mild reaction to the contrast agent?

Extravasation occurs when contrast medium is injected into or leaks into soft tissue.It can cause tissue damage as a result of the toxicity of the agent or through pressure (e.g.,compartment syndrome).Select all the appropriate corrective treatment actions.

Catheters are available in a variety of lengths and shapes,each with a specific advantage.Select the true statement about a pigtail catheter that describes its indications for use.

Select the statement that correctly describes the mechanism of action of contrast media.

Contrast media-induced nephrotoxicity (CIN)can occur as a result of a physiologic change when a transient increase in blood flow is then followed by a longer period of decreased blood flow to the kidneys,after the administration of contrast media.Which statement best describes a true risk factor for CIN?

What type(s)of devices,supplies,or agents are needed for procedures that are designed to occlude a vessel or aneurysm?

An interventional radiology procedure for the correction of a blocked or narrowed blood vessel is a(n):

Distance is key to providing protection during fluoroscopy because radiation exposure follows the inverse square law.(For example,the exposure at 2 meters from the source will be only one fourth as much as the exposure at 1 meter's distance.)When positioning the patient relative to the fluoroscopy image intensifier/C-arm,the patient should be placed as far away from the ___ and as close to the __as possible for optimal image quality and minimum radiation dose to the patient's body.

Fluoroscopy time should be limited as much as possible.What measures aid OR staff to limit the time of live fluoroscopy?

Small amounts of a thrombolytic drug can be instilled into portacaths and aspirated to ensure patency of the device.An example of a true statement regarding thrombolytics is:

Shielding is the third method of protection.Lead aprons with a minimum of 0.5 mm of lead and a thyroid shield are used to reduce radiation exposure and should be worn by staff for protection.The patient should be shielded as well,if appropriate,when the lead shield will not interfere with the area being imaged.Select the statement regarding patient shielding that is true.

Karen Trainor is a perioperative nurse working in the interventional radiology suite as a sedation nurse.She is preparing to provide moderate procedural sedation to Aron Whitten,an ASA class III 52-year-old man,for an endoscopic retrograde cholangiopancreatography (ERCP).The radiologist will probably order midazolam and fentanyl for the patient.Karen has assessed the patient's health history,allergies,baseline vital signs,and lab results and has performed an airway assessment.Because Aron will be positioned on his anterolateral left side,he may inadvertently tilt more to the left,which can impede his airway.Karen is preparing for any airway emergency.What measures will she employ as a risk reduction strategy to prepare for extreme airway management?

Select the diagnostic and interventional radiology procedure that is not classified as a vascular procedure.

What are the indications for using a power injector during an interventional radiology vascular procedure?

Most interventional radiology procedures are initiated with the Seldinger technique,which employs a guidewire fed through the lumen of a puncture needle inserted into a vessel.This is the essence of the catheter-based intervention used in such fields as interventional radiology and cardiology;it provides a less invasive and safer means of access to vessels.Number the steps of the Seldinger technique in the appropriate order. a.Threading of catheter over guidewire b.Placement of needle in lumen of vessel (inner cannula removed) c.Removal of needle (guidewire remains in place) d.Removal of guidewire e.Insertion of needle f.Insertion of guidewire

Celeste Barney and Amanda Vail,two experienced perioperative nurses,are orienting two new surgical technology students to the orthopedic service for their 6-week clinical rotation.Today they are focusing on how to properly wear,care,and handle lead aprons and protective radiologic apparel.Of the list of orientation content topics,which are considered risk reduction strategies for protection from inadvertent radiation exposure?