Diagnostics Flashcards
Upper GI tract study (Barrium Swallow)
Description
examintation of the upper GI tract under fluoroscopy after client drinks barrium sulfate
Upper GI tract study (Barrium Swallow)
preprocedure
no food or drink 8 hours beforehand
Upper GI tract study (Barrium Swallow)
postprocdure
laxative maybe prescribed
increase oral intake
stools will be chaulky white for 24-72 hours
monitor for bowel obstruction
capsule endoscopy
description
wireless camera that client swallows that detects small bleeds or changes in SI
client wears a small receiver
capsule endoscopy
preprocedure
bowel prep prescribed - clear liquid diet night before
NPO for 3 hours before exam and after swallow
Gastric analysis
description
NG tube into stomach then contents are aspirated and analyzed for pH, appearance, volume
q15 min for 1 hour
Gastric analysis
procedure
q15 min for 1 hour
histamine or pentagastrin may be admin subQ to stim secretion
Gastric analysis
preprocedure
fasting for 12 hours before
no tobacco or gum chewing for 24 hours before
meds that stimulate gastric secretions are witheld for 24-48 hours
Gastric analysis
postprocedure
pt resumes normal activities
if samples not tested within 4 hours refrigerate
Upper GI endoscopy (esophago-gastro-duodeno-scopy)
description
scope from the esophagus to duodenum
viewing walls and can collect tissues
Upper GI endoscopy
Preprocedure
NPO 6-8 hours before
local anesthetic (spray or gargle) use
meds to reduce secretions and relax smooth muscle
pt on left side for saliva drainage and for scopy passage
airway patency and O2 monitored (keep emergency equipment on hand)
Upper GI endoscopy
postprocedure
monitor vitals
NPO until gag reflex returns 1-2 hours
monitor for signs of perforation (pain bleed elevated temp difficulty swallowing)
bed rest for sedated pts
treatments for sore throats
Fiberoptic colonoscopy
description
view lining of LI can take biopsies and polypectomies
cardiac and resp functions are monitored continuosly
pt on left side with knees to chest
Fiberoptic colonoscopy
preprocedure
adequate colon cleansing via clear liquid diet on the day before the test
NPO 4-6 hours before the test
moderate sedation IV
meds for smooth muscle relaxation
Fiberoptic colonoscopy
post procedure
monitor VS
bed rest until alert
monitor for signs of bowel perforations and peritonitis
passing gas, fullness, mild cramping is expected for several hours
report any bleeding to PCP
Laparoscopy
description
performed with fiberoptic Laparoscope allowing for direct visualiztion of organs and structures within abd
biopsies can be optained
endoscopic retrograde chol-angio-pancreato-graphy
description
examination of hepatobiliary system is performed via a flexibe endoscope inserted into the esophogaus to duodenum
if meds are used pt is monitoered for resp or CNS depresssion, hypotension (HoT), oversedation, and vomiting (V)
Are clients takign oral liquid bowel cleansing preperations or enemas at RF anything?
Yes
Fluid and electrolyte imbalances
signs of bowel perforations and peritonitis
abd guarding
elevated temp and chills
pallor
abd distention and pain
restlessness
TC and TP
endoscopic retrograde chol-angio-pancreato-graphy
preoperation
NPO 6-8 before
ask about contrast media allergies
moderate sedation used
endoscopic retrograde chol-angio-pancreato-graphy
post procedure
monitor VS, return of gag, perforation and peritonitis
Magnetic Resonance Cholangiopancreatonprahy (MRCP)
Description
used of magnetic fields to visualize the billiary and pancreatic ducts in a noninvasive way
Magnetic Resonance Cholangiopancreatonprahy (MRCP)
preoperation
same as ERCP
NPO for 6-8 before hand
ask about contrast media allergy
moderate sedation is used
Magnetic Resonance Cholangiopancreatonprahy (MRCP)
postprocedure
same as ERCP
monitor VS, return of gag reflex, pertonitis, perferation
Endoscopic ultrasoundography
description
images the wall of the GI and digestive organs
Endoscopic ultrasoundography
pre and post procedure
care is similar to that of an endoscopy
what should be monitored for after an endoscopy?
the return of the gag reflex
increase risk of asperation
do not give anything by mouth
Computed Tomography (CT)
Description
noninvasive cross dimensional view that can detect tissue densities in the abd such as the liver spleen pancreas and biliary tree
can be done with or without contrast
CT preprocedure
NPO for 4 hours
assess for allergies if contrast is being used
CT postprocedure
none
Paracentesis procedure
Get informed consent
get VS and weight
pt is upright
monitor VS (**BP and puslse–>can point to vasodilation paracentecesis) and comfort pt
Dress the puncture site
measure fluid removed
Document
Paracentesis Postprocedure
Monitor VS, and for hypovolemia, electolyte loss, mental status changes, encephalopathy, and hematuria
Measure Fluid collected and send to lab
use dry sterile dressing
measure abd girth and weight
The rapid removal of fluid from the abd cavity during paracentesis can cause what
decreased abd pressure
causes vasodilation and results in shock
monitor HR and BP closely
Liver Biopsy
Description
needle insertion into the abd wall to obtain a tissue sample for biopsy and microscopic examination
Liver Biopsy
Preprocedure
Assess coagulatoin studies (PT, PTT, platelet counts)
admin sedative as prescribed
pt is placed in supine or left lateral to expose right side of upper abd
Liver Biopsy
postprocedure
assess VS and biopsy site for bleeding
monitor for pertonitis
maintain bed rest for several hours
place pt on right side with pillows under the costal margin for 2 hours to lower RF bleeding and tell them to avoid coughing or straining
tell them to avoid heavy lifting or heavy exersice
Stool specimens
descriptions
inpection for consistancy, color and occult blood
feacal urobilinogen, fat, N2, parasites, food,
Quantitative samples must be refrigerated if tested at 24-72 hours
some tests require specific diets
Urea breath test
description
detects precence of H. pylori that causes peptic ulcer disease
can also be tested by blood test
Urea breath test
procedure
pt eats capsule of carbon labled urea and gives a breath sample at 10 -20 min later
Urea breath test
what to avoid
antibiotics (ATB) and bismuth subsalysalate need to be avoided for 1 month before hand
sucralfate and omeprazole for 1 week
cimetidine, famotidine, ranitidine and nizatidine for 24 hours
esophageal pH testing for GERD
to diagnose or evaluate treatment of GERD
probe through nose and into esophagus and pH is tested over 24-48 hours
Liver and pancreas lab studies
tests what
AST
ALT
ALP
PTT
Ammonia NH3
Cholesterol
bilirubin
amylase
lypase
normal ALP
38 - 126 U/L
normal AST
0-35 U/L
normal ALT
4-36 U/L
normal PTT
11 - 12.5 sec
normal ammonia
10 - 80 mcg/dL
normal cholesterol
< 200 mg/dL
normal bilirubin
total
indirect
direct
- 3 - 1.0
- 2 - 0.8
- 1 - 0.3
mg/dL
normal amylase
60-120 somogyi units/dL — 100 - 300 U/L
normal lipase
0-160 U/L
