BE Flashcards
What does a barium enema examination demonstrate? & when is it performed?
The large bowel (colon)
This examination is performed when patients have a change in bowel habits, experience abdominal pain or rectal bleeding, or if diverticulitis or polyps are suspected.
What is required for successful barium enema examination preparation?
Intestines must be completely empty
Typically involves a restricted diet for two days, taking a laxative the evening before, and fasting after midnight.
What type of gown should patients wear during a barium enema examination?
A hospital gown without metal snaps
Metal can interfere with the accuracy of the images.
Who performs the barium enema examination?
A radiographer and a radiologist
The radiographer prepares the patient and takes initial images, while the radiologist interprets the images.
What is the purpose of liquid barium in a barium enema?
To allow radiographic visualization of the gastrointestinal tract
Barium coats the walls of the lower digestive tract, casting shadows for x-ray recording.
What sensations might a patient experience during the barium administration?
Pressure and fullness in the bowel
Patients may also have an urge to defecate.
What is a double-contrast barium enema examination?
An examination that introduces air along with the barium solution
This allows for more detailed images of the colon.
What should patients do after the barium enema examination?
Expel the barium and increase water consumption
Barium may make stools white for a few days, which is normal.
True or False: A radiologist specializes in the diagnostic interpretation of medical images.
True
Fill in the blank: The radiographer will determine the amount of _______ necessary to produce a diagnostically useful image.
[radiation]
What should a woman of childbearing age disclose before a barium enema examination?
Possibility of pregnancy and date of last menstrual period
This is important because the examination exposes the pelvic area to radiation.
What happens to the barium after the examination?
It is expelled through the toilet facilities
The radiographer may take another x-ray image to check for remaining barium.
What sensation may patients feel during the introduction of air in a double-contrast examination?
Cramps or bloating sensation
Patients should try not to expel the air or barium.
How does barium behave in the colon during the examination?
It clings to the walls rather than filling the colon
The air expands the walls of the colon for better imaging.
What will your personal physician do after reviewing the radiographs?
Receive a report of the findings and discuss results with you
They will also discuss any further procedures if necessary.
What is the expected change in stool color after a barium enema?
Stools may appear white for a few days
This is a normal reaction to the barium.
What should patients do if they experience constipation after the examination?
Tell their doctor
They may be advised to increase water consumption or take a laxative.
What happens to the radiation exposure during the barium enema examination?
It passes through the patient immediately
Similar to radiation produced during any other x-ray procedure.
Imaging the colon types
Colonoscopy
Virtual colonoscopy
Sigmoidoscopy
Barium enema
Colonoscopy
Performed by
Diagnostic or therapeutic
What is it for?
What does it require?
Performed by physician
Diagnostic and therapeutic
95% sensitivity for colon lesions
Requires: preparation
Virtual colonoscopy
What is it and is it diagnostic or therapeutic?
Five minute CT procedure
Diagnostic only
Sigmoidoscopy
Performed by
Diagnostic or therapeutic
Performed by physician using a sigmoidoscope
Diagnostic and therapeutic
Barium enema
Performed by radiology with contrast material in colon
Diagnostic only
COLON preparation
For?
Wht kind of pts?
Required for what kind of exams?
Used for bowel cleansing and to promote defecation
Outpatient and can be self-administered
Required for contrast, barium enema exam & endoscopy
Typical preps include
Stool softener – oil base solution
Dietary restrictions – low residue diet
Purgation – laxatives
Hydration plenty- of clear liquids 24 hours before procedure
Why do you need hydration for colon preparation?
Maintain bodies, fluid levels and blood pressure and it can provide a small degree of nutrition
Cleansing enemas
Used to
When are they administered?
Relieve constipation
Administered to patients the morning of exam
What kind of patients present unique variations to prep
Diabetic patients
Giving enemas until clear means that
Fluid is expelled with no fecal matter present
Enema types
Tapwater – hypotonic
Hypertonic – fleet enema
Saline – safest used on infants
Oil retention
Soapsuds solution
What is the purpose of a barium enema?
To diagnose pathologic conditions of the colon or lower gastrointestinal tract
Barium enema is a diagnostic imaging procedure that uses barium sulfate as a contrast agent.
What type of catheter may be used in a barium enema?
A catheter with a plain tip or an inflatable cuff attached
The inflatable cuff is often referred to as a ‘balloon.’
What is the function of the inflatable cuff during a barium enema?
To hold the catheter in place and prevent involuntary expulsion of barium
The cuff is inflated after the catheter tip is inserted.
What is the capacity of the bags in an empty barium enema kit?
3000 cc’s of fluid
This capacity is important for holding the barium solution used in the procedure.
What is the atomic number of Barium that provides optimum contrast?
56
What are the two forms in which Barium can be available as a contrast agent?
Premixed or radiopaque powder
In what type of studies is Barium a popular contrast agent when bowel perforation is NOT suspected?
Enteric studies
What is an important consideration when using Barium as a contrast agent?
Bowel wall coating
What form of Barium is available in a prepared, prepackaged powder?
Suspension mixed with water
How far above the table is the bag of Barium usually suspended?
Up to 30 inches
Is Barium used if bowel perforation or leakage is suspected?
No
What water-soluble contrast is mentioned as an alternative to Barium?
Gastrografin
What is the chemical name for Gastrografin?
Diatrizoic acid
What is a Double-Contrast Barium Enema used for?
Used for polyps, history of colorectal cancer, and rectal bleeding
Excellent for outlining colon mucosa.
What is the appearance of the positive agent in a Double-Contrast Barium Enema?
White
Barium is the positive agent.
What is the appearance of the negative agent in a Double-Contrast Barium Enema?
Black
Air is the negative agent.
What are the advantages of using a Double-Contrast Barium Enema?
Visualize bowel wall lining, outline colon mucosa
Very popular with clinicians.
What patient position is recommended at the start of a Double-Contrast Enema?
Prone position
The R/F table is slightly in Trendelenburg position.
What is administered first during a Double-Contrast Enema?
Barium
Followed by air.
What happens after the barium is administered in a Double-Contrast Enema?
Patient turned into various oblique positions
This helps move barium into colon compartments.
What is the purpose of administering more air during a Double-Contrast Enema?
To contrast with barium adhering to colon mucosa
Enhances visualization.
What is the goal of taking radiographic images during a Double-Contrast Enema?
To visualize anatomy
Allows assessment of polyps and mucosal irregularities.
Fill in the blank: In a Double-Contrast Barium Enema, barium is a _______ agent.
Positive
Positive agents are radioopaque.
Fill in the blank: Air is a _______ agent in a Double-Contrast Barium Enema.
Negative
Negative agents are radioluent.
Single contrast barium enema
Larger volume of barium
Axis barium is drained back into bag. The tip is removed and the patient is sent to the toilet to evacuate as much of the barium as possible.
Post evacuation images taken
Important patient concerns
Keep firmly in rectum
Relax, abdominal muscles to reduce intra-abdominal pressure
Use deep oral breathing to prevent spasms and cramps -CAN CAUSE CESSATION OF PROCEDURE
Take pt attention away from enema
When perforation of the bowel is suspected
Water soluble iodine compounds (Gastrografin) are the only acceptable contrast media
What is a consideration regarding barium in a barium enema procedure?
Barium is naturally hydroscopic and can cause patient dehydration.
Hydroscopic substances absorb moisture, which can lead to dehydration if not properly managed.
What color are patient stools typically until barium is fully defecated?
Gray or white.
This change in stool color is due to the presence of barium in the digestive system.
Why is it important to stress defecation after a barium enema?
To remove residual barium.
Retained barium can lead to complications such as constipation and dehydration.
What dietary changes should a patient make after a barium enema?
Increase fluid intake and dietary fiber.
These changes help facilitate the elimination of barium from the body.
What are post-examination instructions to patients considered?
Important.
Proper instructions can help prevent complications and ensure patient recovery.
What are colostomy patients referred to medically?
Ostomate patients.
This term encompasses individuals who have undergone ostomy surgeries.
What is the most common complication for colostomy patients?
Wound infection.
Infection can occur at the stoma site and is a significant concern post-surgery.
How is contrast administered in colostomy patients?
Through a patient stoma.
This method allows for imaging studies to be conducted in patients with colostomies.
What should patients have over their stoma?
A dressing.
Dressings help protect the stoma and prevent infection.
Colostomy types
Sigmoid
Transverse
Double barrel
Loopogram
Fluoroscopic study of small bowel and colon throat skin surface connection for the urinary bladder
Why is colonoscopy popular?
95% sensitivity for colon lesions
