Wednesday, December 10, 2008

Praning5254 Intravenous Pyelography (IVP)

- also known as Intravenous Urography


- a radiographic contrast study of the urinary system to determine renal function


- includes the kidneys, the bladder, the ureters, and the urethra (urinary tract)


- shows the size, shape, and position of the urinary tract, and it can evaluate the collecting system inside the kidneys.



Indications


  • to identify diseases of the urinary tract, such as kidney stones, tumors, enlarged prostate or infection
  • used to look for problems with the structure of the urinary tract that were present from birth (congenital).

Patient Preparations


  • Fasting ( 6-8 hrs NPO, no breakfast)
  • Laxatives (4 tablets dulcolax at bedtime, 1 suppository at early in the morning)
  • 12 hours dehydration (adults), no fluid intake

Materials


  • VF (PNSS, sterile water, 500cc)
  • IV set
  • Needle(butterfly) – gauge 19/venflon
  • Syringe with needle
  • Contrast media – iodinated compound
  • Antihistamine ampule
  • Plaster

Requirements:


  • Ask for patient’s history of allergy, especially on medications and history of asthma
  • Creatinine clearance – including blood examination to help assess kidney function

Procedure


  1. Scout film (KUB)
  2. Insertion of IV line
  3. IV/ID test of CM (30 min-1 hr, 1 cc)
  4. Check for signs of blushing, wheals or seizures
  5. Introduction of CM (50 ml)

Method Of CM Administration


  • Fast drip
  • Bolus

Exposures


  • 5 min shot kidneys -------- 11x14 AP
  • 15 min shot kidneys and uterus -------- 14x17 AP
  • 30 min shot KUB -------- 14x17 AP
  • Post voiding UB/KUB --------- 10x12/14x17 AP

Note:


  • Lateral and oblique shots are taken during the 30 min shot prn

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