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RADT 2043 Chapter 12
Patient Care for Gastrointestinal Procedures
| Question | Answer |
|---|---|
| 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
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