Exam 29: Interventional and Image-Guided Procedures

The new neuroangiography interventional room has a biplane configuration.What is the correct description of a biplane configuration?

Reactions to gadolinium-based contrast are less frequent than those observed with iodinated contrast media and are usually mild and well tolerated.What potential severe reaction must the nurse be prepared for?

Gastric variceal (GV)bleeding is a major complication of portal hypertension and is associated with high morbidity and mortality.Which interventional procedure is used for treating GV?

Postpartum hemorrhage remains a common health problem and is the main cause of pregnancy-related maternal death worldwide.Which therapeutic intervention may be used postpartum hemorrhage?

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.

Some of the new complex interventional procedures may require prolonged fluoroscopic guidance to perform and complete the procedure.Which patient safety strategy will reduce exposure risk to the patient?

Acute adverse reactions to iodinated and gadolinium containing contrast media can be either allergic-like or physiologic.Sound clinical judgment should be used to determine when and how aggressively an acute reaction should be treated,however,many mild reactions resolve during a period of observation without treatment.Which statement by the patient would alert you to the possibility that the patient was having a mild reaction to the contrast agent?

Needles,guidewires,sheaths,catheters,and vascular closure devices are several specialty items used for IR procedures.A sheath is commonly inserted at the arterial or venous puncture site.What is the function of the sheath?

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

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

Distance is key to providing protection during fluoroscopy,because radiation exposure follows the inverse square law.(e.g.,the exposure at 2 m from the source will be only one-fourth as much as the exposure at 1 m 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.

Most IR procedures are initiated with the Seldinger technique.The first step of the technique is placement of the needle in the vessel.Select the step below that is performed after the needle is placed in the lumen of the vessel.

The principle of ALARA,as low as reasonably achievable,is a protective measure designed to protect both patients and staff.What are the three principles of ALARA?

Angiography uses fluoroscopy and contrast to image anatomic and pathologic changes in vascular anatomy.What is an example of coronary angiography?

The IR procedure that is used to correct a blocked or narrowed blood vessel and restore flow is called:

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

In the IR suite,the concomitant use of various imaging modalities creates a different environment and new dimension of patient care.Because IR is procedure based,it requires a higher standard of patient care than general radiology.The scope of IR nursing practice is diverse and includes which roles?

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.

Contrast media-induced nephrotoxicity (CIN)results from administering intravascular radiographic contrast material.After the administration of contrast,a transient increase in blood flow is then followed by a longer period of decreased blood flow to the kidneys.Which statement best describes a true risk factor for CIN?

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