Saturday, September 23, 2006

#41 Discuss the assessment needed for the client who is going to have a diagnostic study using radiopaque media.

Radiopaque agents are drugs used to help diagnose certain medical problems. They contain iodine, which absorbs x-rays. Depending on how they are given, radiopaque agents build up in a particular area of the body. The resulting high level of iodine allows the x-rays to make a ``picture'' of the area.
Before Using This Medicine
In deciding to use a diagnostic test, any risks of the test must be weighed against the good it will do. This is a decision you and your doctor will make. Also, test results may be affected by other things. For radiopaque agents, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to iodine, to products containing iodine (for example, iodine-containing foods such as seafood, cabbage, kale, rape [turnip-like vegetable], turnips, or iodized salt), or to any radiopaque agent. Also tell your doctor if you are allergic to any other substance, such as sulfites or other preservatives.
Pregnancy—Studies have not been done in humans with most of the radiopaque agents. However, iohexol, iopamidol, iothalamate, ioversol, ioxaglate, and metrizamide have not been shown to cause birth defects or other problems in animal studies. Some of the radiopaque agents, such as diatrizoates have, on rare occasions, caused hypothyroidism (underactive thyroid) in the baby when they were taken late in the pregnancy. Also, x-rays of the abdomen are usually not recommended during pregnancy. This is to avoid exposing the fetus to radiation. Be sure you have discussed this with your doctor.
Breast-feeding—Although some of these radiopaque agents pass into the breast milk, they have not been shown to cause problems in nursing babies. However, it may be necessary for you to stop breast-feeding temporarily after receiving a radiopaque agent. Be sure you have discussed this with your doctor.
Children—Children, especially those with other medical problems, may be especially sensitive to the effects of radiopaque agents. This may increase the chance of side effects.
Older adults—Elderly people are especially sensitive to the effects of radiopaque agents. This may increase the chance of side effects.
Other medical problems—The presence of other medical problems may affect the use of radiopaque agents. Make sure you tell your doctor if you have any other medical problems, especially:
Asthma, hay fever, or other allergies (history of)—If you have a history of these conditions, the risk of having a reaction, such as an allergic reaction to the radiopaque agent, is greater
Type 2 diabetes mellitus—There is a greater risk of having kidney problems
High blood pressure (severe) or
Pheochromocytoma (PCC)—Injection of the radiopaque agent may cause a dangerous rise in blood pressure
Kidney disease (severe)—More serious kidney problems may develop; also, the radiopaque agent may build up in the body and cause side effects
Liver disease—The radiopaque agent may build up in the body and cause side effects
Multiple myeloma (bone cancer)—Serious kidney problems may develop in patients with this condition
Overactive thyroid—A sudden increase in symptoms, such as fast heartbeat or palpitations, unusual tiredness or weakness, nervousness, excessive sweating, or muscle weakness may occur
Sickle cell disease—The radiopaque agent may promote the formation of abnormal blood cells
Radiopaque agents are taken by mouth or given by enema or injection. X-rays are then used to check if there are any problems with the stomach, intestines, kidneys, or other parts of the body.
Some radiopaque agents, such as iohexol, iopamidol, and metrizamide are given by injection into the spinal canal. X-rays are then used to help diagnose problems or diseases in the head, spinal canal, and nervous system.
The doses of radiopaque agents will be different for different patients and depend on the type of test. The strength of the solution is determined by how much iodine it contains. Different tests will require a different strength and amount of solution depending on the age of the patient, the contrast needed, and the x-ray equipment used.

Found on Medline Plus
I think most important part is Allergies to iodine and or shellfish and
past and current medical history

1 comment:

Kelly said...

Just a couple things to add to this:

If patient is having Upper GI series, then must assess when last meal was usually NPO or clear liquid diet for 1-3 days prior (fasting is usually required) and if followed physician orders on procedure prep (usually have to drink special solution to clean out the GI system prior to this procedure) Contrast media works best when GI system is empty.

If patient is having lower GI procedure, often NPO must assess last meal, last BM, and again if followed Dr. orders for procedure prep. (usually drink solution (laxative) to clean out GI system but usually have cleansing enemas as well) Contrast media works best when GI system is empty.

Lewis pg.961-966