Question

A 65-year-old patient is recovering from a recent total Rt. knee replacement. The patient was complaining of dyspnea /shortness of breath. The patients RN has mentioned the following test results; elevated d-dimer, low O2 sats, and a Rt. Lower leg DVT seen on a doppler ultrasound done earlier today. The patient’s Dr. fears the patient may have a pulmonary embolism. Please address the following elements;

The patient has a 24 gauge IV in the back of the hand. The patient also has an implanted mediport. Can contrast be injected into this implanted port? Who must access the port? List methods of identifying if a port is power injectable. What precautions must be addressed following the injection of contrast media? The patient has the following lab values BUN 40, Creatinine 1.6 mg/dl. The patient states a history of mild hypersensitivity (mild hives and itchy watery eyes) to iodinated contrast media. What concerns do you have regarding this order and the patient’s medical history?

Answer 1

As this patient is concerned it is possible to give contrast injection through implanted port,

It is to be carried out by an radiologist.

So it is better to give iv contrast through peripherally inserted line. ( that is iv line behind the hand)

As this patient is concerned his serum creatinine is increased( normal is 0.7 to 1.4),

a) minimal dose of contrast agent.

b)check for allergic reaction( as history of itchy eyes)

c) he is in hypercoagulable state can leave a chance for pulmonary embolism.