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RADT 2043 Chapter 12

Patient Care for Gastrointestinal Procedures

What are adverse effects? The development of undesired side effects or toxicity caused by the administration of drugs
What is the alimentary canal? The organs of digestion; the digestive tract
What is a colostomy? An artificial opening (stoma) created in the large intestine and brought to the surface of the abdomen for the purpose of evacuating the bowels.
What is diverticulitis? Inflammation of a sac or pouch protruding from the walls of the intestines, especially the colon
What is flatus? Gas expelled from the digestive tract though the anus
What is ileostomy? An artificial opening (stoma) erected in the small intestine (ileum) and brought to the surface for the purpose of evacuating feces.
What is a nasogastric tube? A thin tube that is inserted through the nose and into the stomach for the purpose of instilling substances or for the removal of substances
What is an ostomy? General term for an operation in which an artificial opening is formed.
What is peritonitis? Inflammation of the serous membrane lining the abdominal cavity and surrounding the abdominal organs
What is a stoma? An opening in the body created by bringing a loop of bowel to the skin surface.
Most GI procedures are now performed in what modality? CT
Imaging of the liver, gallbladder and biliary is now done in what modalities? US, and Nuc Med
What do negative contrast agents do? Decrease organ density to produce contrast.
What do positive contrast agents do? Increase organ density to improved radiographic visualization
What are the most commonly used negative contrast media? Carbon dioxide and air
What is a complication associated with negative contrast use? An inadvertent injection of air into the bloodstream causing an air embolus.
What positive contrast agents are used commonly? Barium and iodinated contrast.
Which is more dangerous to patients...barium or iodinated contrast? Iodinated contrast.
What color is barium? A white or pink color
How is barium used? In suspension to take by mouth for upper GI, in the rectum for lower GI or through a duodenal tube to visualize the jejunum and ileum.
If there is a double contrast order including barium, what is usually the other contrast agent? Air (to see small lesions)
Where could barium go if there is a break in the gastric mucosa? respiratory tract, the peritoneal cavity or the bloodstream
Who is more prone to aspirating barium during a barium swallow study? The elderly and those with swallowing difficulties.
What are complications to aspirating barium? Less air taken in by alveoli; interfere with chest radiographs; productive cough; fever; elevated white blood cell count; aspiration pneumonia
What should be used if a perforation of the GI tract is suspected? water-soluble iodinated contrast
Barium sulfate can cause what? Constipation
If a patient says that barium makes them feel nauseous, why is this important to consider? Vomiting could cause barium to be aspirated.
What is the correct sequence for scheduling exams in the imaging department? Fasting exams in the morning first; All exams without contrast; US and nuc med before contrast studies; Iodinated contrast before barium contrast; lower GI studies with barium before upper GI with barium.
What is a low-residue diet? no tough meats, raw veggies, pul, whole grain breads and cereals, nuts, peanut butter, coconut, olives, pickles, seeds and popcorn, dried peas and beans.
What is usually prescribed 24 hours before the examination? A clear liquid diet.
The afternoon before the examination, the patient is given what? magnesium citrate or another laxative.
What should be done regarding culture and lower GI exams? Talk to the patient to gain an understanding of how best to proceed.
What are the types of cleansing enemas? saline enema, hypertonic enema, oil-retention enema, tap water enema, soapsuds enema.
Who orders cleansing enemas? The physician
What needs to be considered with cleansing enemas? The osmolarity of the solution
Hyperosmolar fluids can create what? dehydration
Hypo-osmolar fluids can create what? Fluid toxicity
Why are saline enemas effective? They are the same osmolarity as the interstitial spaces around the colon
What does a hypertonic saline solution do? Pulls fluid from the interstitial spaces into the colon.
Another name for a hypertonic saline enema? Fleet enema.
What do oil-retention enemas do? Lubricate the rectum and colon and soften the fecal material.
Tap water enemas could cause what? fluid toxicity
What do soapsuds enemas do? Increase the irritation of the intestine to promote peristalsis
What is barium peritonitis? Barium leakage into the peritoneal cavity
Why are BEs performed? Find the reason for abdominal pain; a change in bowel habits; location of parasites; or why blood, mucus, or pus is found in the stool.
Double contrast BE require what kind of tube? A Dual-lumen tube. One for inflatable cuff and one for air insertion
What does the inflatable cuff do? Holds enema tip in place and makes sure that barium doesn't come out.
What is barium good for? Coating the mucosal walls
Amount of barium for a single contrast study? 1500 mL
What would barium mixed with saline do? Prevent electrolyte imbalance
What is important in regards to tubing before inserting the enema tip? No air in tubing.
For double contrast studies, what is required of the patient? Air to get barium to cecum and then turning 360 degrees to coat mucosal wall.
What can be given a patient if they experience muscle spasms? Glucagon
Procedure for placing an enema tip? Sims position patient draped; clean gloves; heavily lubricate enema tip; patient exhales slowly as tip is inserted 3 or 4 inches or until it passes anal sphincter; Once placed return to supine position
Never use an inflatable enema tip on who? An infant or child undergoing a BE
What should be determined before giving glucagon? If a patient is an insulin-dependent diabetic or has glaucoma
Air and barium together are good at diagnosing what? Polyps and diverticula of the bowel.
What are normal sensations during this exam? Cramping and the urge to defecate.
What should be done before removing the enema tip? Deflate the retention cuff
What is a common side effect of BEs and how can it be relieved? Constipation and increasing fluid intake
What diseases might include the creation of a stoma? cancer, diverticulitis, and ulcerative colitis
Ostomy causes a major change in what? Patient's body image
Never place a stoma patient in what position because it causes damage to the patient's ostomy site? In the prone position.
What tip is used for a BE with a colostomy patient? A cone tip.
What are types of exams for the upper GI tract? Upper GI series and a small bowel follow through.
What are qualities of barium? chalky, not an unpleasant flavor
How long could a SBFT exam take? A couple of hours
What are barium studies of the upper GI tract commonly used to diagnose? pathologic conditions of the pharynx, esophagus, stomach, duodenum, and jejunum.
If barium is in the bloodstream, what can happen? tissue necrosis.
What can autonomic dysreflexia cause? HA, strokes, hemorrhage, dizziness, and seizures
Created by: Cjenki10