Chapter 19 Non Aseptic Technique Flashcards
Describe the insertion, care, and removal of nasogastric tubes Assist a patient with the use of the male urinal Assist a patient with a bedpan Describe the common types of enemas Describe the procedure for a cleansing enema State the need for patient teaching regarding the barium enema—preparation, procedural, and post-procedural Differentiate between the single-contrast and double-contrast barium enemas Describe the procedure for a colostomy barium enema State the needs of a colostomy p
What is Barium
Bulky, fine white powder, without odor or taste and free from grittiness: used as a contrast medium in radiography of the digestive tract
Bedpan
Vessel for receiving the urinary and fecal discharges of a patient unable to leave his or her bed.
Colonoscopy
Endoscopic examination of the large bowel and the distal part of the small bowel with a charge-coupled device camera or a fiberoptic camera on a flexible tube passed through the anus. Biopsies can be performed during the procedure. Excellent method to identify small polyps or masses.
Colostomy
Surgical creation of an opening between the colon and the surface of the body; also used to refer to the opening , or stoma, that is created.
Defecation
Evacuation of fecal material from the intestines
Emesis Basin
Kidney-shaped vessel for the collection of vomitus
Enema
Liquid injected or to be injected into the rectum
Enterostomal Therapist
Health professional (usually a nurse) with special training and certification in the care of ostomies and related concerns
Flatus
Gas or air evacuated through the anus
Fowler’s Position
Position in which the patient’s head is raised 18 or 20 inches above the flat position; the knees are also raised
Hydration
Term used to indicated that a liquid substance contains water
Loopogram
The radiographic evaluation of the small and large bowel that has been connected to the skin surface as a substitute for the urinary bladder with an ostomy.
Low Residue Diet
Diet that gives the least possible fecal residue- such as gelatin, sucrose, dextrose, broth and rice.
Lumen
Cavity of channel within a tub or tubular organ. (plural- lumina)
Nasogastric (NG) Tubes
Tubes of soft rubber or plastic inserted through a nostril and into the stomach; for instilling liquid foods or other substances or for withdrawing gastric contents.
Osomate
One who has undergone enterostomy or ureterostomy
Perineum
Region between the thighs, bound in the male by the scrotum and the anus and in the female by the vulva and the anus.
Purgation
Catharsis; relief of fecal matter affected by a cathartic.
Sigmoidoscopy
Procedure used to see inside the sigmoid colon and rectum with a flexible tube that has a camera on the end (sigmoidoscope) and is placed through the anus.
Sim’s Position
Position in which the patient lies on the left side with the right knee and thigh flexed and the left arm parallel along the back.
Stoma
Opening established in the abdominal wall by colostomy by colostomy, ileostomy, and so forth.
Urinal
Vessel or other receptacle for urine (male and female types)
Virtual Colonoscopy
It is performed on a multislice computed tomography (CT) scanner that takes up to 600 2D and 3D images of the colon in approximately 30 seconds.
Viscosity
Physical property of liquids that determines the internal resistance to shear forces.
What is the most common type of NG tube?
Levin Tube
How can leakage form a double-lumen tube be prevented
The barrel of a piston-like syringe may be inserted into the suction-drainage lumen, and it is pinned to the patient’s gown with the barrel upwards
What should you do with a bed pan after use?
Cover, then empty contents in toilet. Most bed pans today are single use and can be thrown out in the non- regulated trash. Metal pans are to be emptied and sent to SPD for resterilization.
Hypertonic solution is used when?
Hypertonic enema solutions are used with the patient can not tolerate large amounts of fluid. It pulls fluid from the interstitial spaces around the colon. Usually 120-180ml or 4-6oz is usually effective. (Fleet enema)
The normal adult patient should be able to tolerate how much fluid from a cleansing enema
Approximately 500ml of fluid
What should be done if cramping occurs during a BE?
Stop the enema until the cramping has subsided. The patient should also be asked to breath through the mouth to help alleviate the discomfort.
Desirable characteristics of a barium suspension include
- Allow rapid flow
- Allow good adhesion to the mucosa for even coating
- Provide adequate radiographic density in a thin layer
- Lack foam or artifacts
A postural drop in blood pressure can occur after a BE as a result of
Dehydration
With a double barrel colostomy, the proximal stoma delivers _________ and the distal stoma produces ___________.
Proximal delivers stool
Distal produces mucus
Approximately what percentage of colostomy patients have recurrences of cancer?
10%
Describe a Levin Tube
A tube with a single lumen with several holes near its tip
Types of NG tubes
Canor,Keofeed, Miller-Abbott, ad Sengstake-Blakemore
Name the 5 basic types of cleansing enemas
tap water (hypotonic), hypertonic solution, physiologic, soapsuds, and oil retention
Name some clinical indications for a flouroscopic contrast enema.
Diverticular disease, IBS, ulcerative colitis, Crohn’s Disease, Colon cancer screening, incomplete colonoscopy, distal intestinal obstruction syndrome or meconium ileus equivalent in cystic fibrosis patients, abnomal or inconclusive findings on other imaging such as CT, polyps.
Why would you use water soluable iodine compounds such a Gastrographin (diatrizoic acid) rather than barium for a BE?
Suspected bowel perforation. Mega colon and Hirschsprung’s disease.
What is the risk of using a water soluable iodine compounds such a Gastrographin (diatrizoic acid)
They are hyper-tonic. It can cause diarrhea and a sudden reduction in blood volume and is particularly dangerous in neonates and in patient with Hirschsprung’s Disease.
What is Hirschsprung’s Disease?
Disease that affects the large intestine and causes problems with passing stool. The condition is congenital as a result of missing nerve cells in the muscles of the baby’s colon
