9.2 Pharmacology for the Radiographer

Question 1

RULES THAT APPLY TO ALL PARENTERAL DRUG ADMINISTRATION (1)

Answer 1

1. All equipment that penetrates the skin including needles, syringes, and the drug itself must be
   sterile.
2. The patient must be correctly identified.
3. The procedure is explained to the patient and the medication (including contrast media) to be
   administered is identified.
4. If the patient refuses the drug, document the refusal. Do not insist that the patient accept the drug.
5. The skin at the injection site is cleansed with an antiseptic solution until it is as free of
   microorganisms as possible.
6. The antiseptic chosen will be dictated by the institution in which you are employed. Alcohol-based
   preparations are commonly used as many people are allergic to povidone-iodine preparations

Question 2

RULES THAT APPLY TO ALL PARENTERAL DRUG ADMINISTRATION (2)

Answer 2

7. All persons administering parenteral drugs must wear gloves during the procedure to prevent expo
   sure to blood.
8. There must be a physician’s order for all drugs to be administered. This includes contrast media.
9. The five rights of drug administration must be followed.
10. The drug administered must be documented according to the policy of the department.
11. The patient must be observed closely for 1 hour following drug administration for adverse or
    allergic reactions.
12. A patient who has had a sedative, tranquilizing, hypnotic drug may NOT drive him or hers home.

Question 3

part that attaches to the syringe

Answer 3

Hub

Question 4

Needles are made of

Answer 4

stainless steel

Question 5

elongated part of the needle

Answer 5

Shaft

Question 6

hollow tube that runs the length of the shaft

Answer 6

Lumen

Question 7

sharp angulated tip of the needle

Answer 7

Bevel

Question 8

The _____ the lumen, the _____ the gauge of the needle

Answer 8

smaller, larger

Question 9

30-gauge needle is much _____ than a 12-gauge needle

Answer 9

smaller

Question 10

The _____ of the fluid to be injected

determines the gauge selected

Answer 10

viscosity

Question 11

The area for injection and the condition of the patient determine the
_____ chosen

Answer 11

length of needle

Question 12

Syringes also vary in size depending on

the amount of fluid to be injected and Generally range in capacity from _____

Answer 12

1 to 50 mL

Question 13

end of the syringe to which

the needle is fastened

Answer 13

tip

Question 14

body

Answer 14

barrel

Question 15

part that fits into the barrel

Answer 15

plunger

Question 16

are packaged in treated
paper or plastic wrappers to maintain
sterility, and needles are often
attached in the package

Answer 16

Syringes

Question 17

The size of the syringe and the size of

the needle are printed on the _____

Answer 17

package

Question 18

The 3 Basic Principles of Needle and Syringe Sizing

Answer 18

1. Needle Gauge
2. Syringe Size
3. Needle Length

Question 19

syringe capacity measurement for liquid volume

Answer 19

milliliters (mL)

Question 20

syringe capacity measurement for solid volume

Answer 20

cubic centimeter (cc)

Question 21

1 cc is equal to

Answer 21

1 mL

Question 22

are a
serious consequence of incorrect
handling of injection supplies

Answer 22

Needle-stick injuries

Question 23

is the only method by which
radiographers may administer
contrast media parenterally

Answer 23

peripheral intravenous route

Question 24

Designated amount of a drug that is administered at one time,
usually over a period of several minutes

Answer 24

Bolus

Question 25

Usually refers to a larger amount of a drug, a
fluid, or fluid containing a drug or electrolytes
that is administered over a longer period of
time ranging from hours to days

Answer 25

Infusion

Question 26

Contrast Agents may be given by ____,
Both methods require venipuncture: each
requires different equipment

Answer 26

Bolus or Infusion

Question 27

Things to consider when selecting a

venipuncture site:

Answer 27

1. Type of Contrast
2. Length of Time for the Infusion or Bolus
3. Age
4. Physical Condition

Question 28

Veins in the hands and arms should be selected rather than those in the
_____ unless necessary

Answer 28

lower extremities

Question 29

Greater hazard of embolus

formation related to IV infusion

Answer 29

lower extremities

Question 30

Unless a drug is to be injected by bolus, do not select a vein located
over a ____, because any
movement will dislodge the needle or catheter

Answer 30

joint

Question 31

If a vein over a joint is selected, the extremity will need to be _____

Answer 31

immobilized

Question 32

Venipuncture steps (1)

Answer 32

1. Approach the patient, identify him, and assess for latex or iodine allergies. Explain the procedure
   and answer any questions he may have.
2. Wash your hands.
3. Secure the tourniquet over the site selected in such a manner that it can be removed by pulling on
   one end.
4. Instruct the patient to make two or three tight fists to force more blood into the veins to make
   them more visible.
5. Put on clean gloves. Gloves need not be sterile; however, all other equipment used that cleans or
   penetrates the skin must be sterile.

Question 33

Venipuncture steps (2)

Answer 33

6. Cleanse the area for the venipuncture using firm strokes from center of site to outside. Do
   this at least three times using a separate swab each time. Allow the area to dry.
7. Hold the skin taut above or below the insertion site. Insert the needle or catheter bevel side
   up into the vein.
8. When the needle enters the vein, blood returns into the flashback chamber immediately. If
   no blood returns, the venipuncture was not successful.
    If this is the case, remove the needle and obtain a new needle to start the IV and select a new site.
   Apply pressure to the failed area with a sterile gauze pad until bleeding stops.
    If the second effort fails, call a member of the IV team or an anesthesiologist to start the IV

Question 34

Venipuncture steps (3)

Answer 34

9. If blood returns, release the tourniquet, instruct the patient to relax his hand, thread the
   needle is to 1/4 inch further into the vein, and connect the syringe containing the contrast
   agent if a bolus is ordered.
   If an infusion is started, remove the needle from the catheter, thread the catheter into the
   vein, and connect the IV tubing.
   Secure the catheter with narrow nonallergenic tape and/or a transparent dressing.
10. A bolus is administered at the rate ordered. An infusion is begun at the rate ordered by
    the
    physician.
11. Document the procedure including the time the IV was started and the contrast agent
    injected. The radiographer must sign his documentation.

Question 35

The infusion site must be assessed
every _____ to be certain that
the contrast agent is not infiltrating
into the surrounding tissues

Answer 35

30 minutes

Question 36

IV stand must be positioned _____ above the injection site

Answer 36

18 to 24 inches