Intravenous Pyelography

Overview
  • Also known as IVP, pyelography, intravenous urogram or IVU
  • Is a radiological procedure used to visualize abnormalities of the urinary system, including the kidneys, ureters, and bladder
  • Gives a comprehensive view of the patient’s anatomy and some information on the functioning of the renal system
  • Usually done to patient with severe renal colic and a positive hematuria test
  • Used as a way to diagnose chronic pyelonephritis, kidney stones, renal cell carcinoma or RCC, Trnasitional cell carcinoma or TCC, Polycystic kidneys

Intravenous Pyelography

Procedure
  1. A cannula is inserted in the vein usually in the arm where in a contrast media is injected.
  2. Using the X-ray, the contrast media is seen and termed as “renal blush”.
  3. X ray shots are taken in intervals to capture the way it travels inside the urinary system.
  4. After three (3) minutes of X-ray shots, the calices and renal pelvis can now be seen.
  5. After 9 to 13 minutes it goes to the bladder.
  6. The contrast is excreted or removed from the bloodstream via the kidneys.
  7. A post micturition X-ray is then taken in order to compare the images for more evidence of pathology.
Contraindications
  • Patients taking metformin should hold this medication 48 hours before and after the procedure to avoid such interaction.
  • This is not indicated for pregnant women and those who have kidney disease or renal failure.
Adverse Reactions
  1. Nausea and vomiting
  2. Itching
  3. Difficulty in breathing or swallowing
  4. Swelling of the lips and tongue
  5. Low blood pressure
  6. Loss of consciousness
Nursing Considerations
Before the Procedure:
  1. Assess the history of allergy, medications currently taken and risk of pregnancy for women.
  2. Check if consent is properly signed.
  3. Emphasize to the patient that nothing should be taken or ingested 12 hours before the procedure.
After the Procedure:
  1. Monitor the intake and output strictly especially the next 24 hours.
  2. Assess for adverse reactions.
  3. Assess the puncture site for active bleeding
  4. Document the findings properly.
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