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
Procedure
- A cannula is inserted in the vein usually in the arm where in a contrast media is injected.
- Using the X-ray, the contrast media is seen and termed as “renal blush”.
- X ray shots are taken in intervals to capture the way it travels inside the urinary system.
- After three (3) minutes of X-ray shots, the calices and renal pelvis can now be seen.
- After 9 to 13 minutes it goes to the bladder.
- The contrast is excreted or removed from the bloodstream via the kidneys.
- 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
- Nausea and vomiting
- Itching
- Difficulty in breathing or swallowing
- Swelling of the lips and tongue
- Low blood pressure
- Loss of consciousness
Nursing Considerations
Before the Procedure:
- Assess the history of allergy, medications currently taken and risk of pregnancy for women.
- Check if consent is properly signed.
- Emphasize to the patient that nothing should be taken or ingested 12 hours before the procedure.
After the Procedure:
- Monitor the intake and output strictly especially the next 24 hours.
- Assess for adverse reactions.
- Assess the puncture site for active bleeding
- Document the findings properly.
