Diagnostic tests

Question 1

Upper GI test:

this test looks at the___ and ___ with dye.

This patient will be ___ past midnight

Answer 1

esophagus and stomach NPO

Question 2

If you’re NPO can you still smoke? why?

Answer 2

NO; smoking increases GI motility and stomach secretions which affects the test. This patient will be at higher risk for aspiration.

Question 3

BARIUM ENEMA (B.E):

patient needs to be on what kind of diet?

this patient has to consume___ or __ until clear.

they may have to drink a gallon of____.

When your patient is drinking golytely, why can’t they drink it with a straw?

after the barium enema, ALWAYS make sure that the patient has a ___. why?

Answer 3

• clear liquids
• laxative; enemas;

golytely -

they will swallow more air which causes more GI upset.

• bowel movement (post procedure); because the barium needs to come out.

THAT BARIUM NEEDS TO COME OUT BECAUSE IF IT DOES NOT, IT WILL GET HARD AS CONCRETE IN THE INTESTINES. Sometimes, they’ll even surgically remove it.

Question 4

GASTROSCOPY (EGD, Endoscopy):

what kind of diet before?

will they be awake?

they’ll be NPO post procedure until their____ returns.

post procedure, watch for____

Answer 4

• NPO
• sedated
• gag reflex
• perforation (any complaint of new pain or discomfort)

Question 5

Immediately post EGD, you assess that the patient does not have a gas reflex. what do you do?

Answer 5

document the findings because that is expected immediately post egd. they normally spray something in the back of the throat so when they pass the tube, the patient won’t gag as much.

Question 6

The liver is VERY important for____ your body.

What happens when your liver doesn’t work?

another important function of the liver is to help your blood to____ .

if your liver is messed up, the #1 thing you have to worry about is____.

ANYTIME YOU GET A LIVER QUESTION, ALWAYS THINK___ FIRST!

Answer 6

• detoxifying
• you’re not getting rid of toxins like you should and that makes you feel tired all the time
• clot - hemorrhage - HEMORRHAGE

Question 7

When you have a liver problem, what has to be done with medication doses?

WHAT DRUG YOU SHOULD NEVER EVER GIVE TO LIVER PEOPLE?

Answer 7

-decrease them;

because they cannot metabolize it like they should.

-TYLENOL (this dug already attacks your liver, so this will make them worst). and if your liver is being attacked, it’s gonna bleed.

Question 8

What’s the antidote for tylenol overdose?

Answer 8

acytlcisitine mucomyst

Question 9

LIVER BIOPSY:

They’re about to take a needle and puncture into a sick liver, so what are you REALLY concerned about now?

so, before a liver biopsy, what kind of blood tests should your expect to run?

How do you position a patient during a liver biopsy?

How do you position a patient AFTER the biopsy?

Answer 9

• hemorrhage
• clotting studies (pt and ptt)
• supine (flat) with right arm behind the head (no pillow)… we want the patient stable. the doctor is then gonna tell the patient to exhale and hold in order to get the diaphragm out of the way. the patient doesn’t need to be able to hold their breath for an extended amount of time.
• lie on the right side (the affected site) to hold pressure and control bleeding.

Question 10

After a liver biopsy, you are monitoring vital signs and you notice that the patient’s blood pressure has gone from 120/80 - 98/60, while his pulse went from 70 BPM, to 98 BPM. What should you do first?

Answer 10

check the puncture site for hemorrhage because they may have hemorrhaged which caused a decrease in blood volume and lead to shock.

Question 11

PARACENTESIS:

with any liver problem, people usually have____.

paracentesis is the removal of fluid from the____ cavity.

Answer 11

• ascites
• peritoneal

Question 12

How does ascites affect the vascular space?

Answer 12

the fluid that has accumulated in the peritoneum is actually coming from the vascular space. so, the bigger the peritoneum gets , the less volume that’s now in the vascular space. it can make you hypovolemic.

(Robbing fluid from the vascular space)

Question 13

PARACENTESIS:

Before the procedure, this patient must____ first. why?

what position do we put this patient in for this procedure?

anytime you have someone with ascites, think____ troubles.

why do we need to constantly monitor the vital signs?

Answer 13

• pee; its’ a low puncture procedure.. we want their bladder to be small so we wont puncture in.
• any position that is sitting up. because if they were lying down, the fluid would spread everywhere. it would be hard to collect… when they sit up, all the fluid will settle down by gravity. when this happens, the intestines will actually float on top of the fluid which will create more room for the water.
• breathing; they cannot lie flat. - since we are pulling fluids, they can go into shock.