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Gastrointestinal Procedures > Gastrointestinal System Procedures > Flashcards

Gastrointestinal System Procedures Flashcards

1
Q

Preparation for Upper GI Series/ Barium Swallow

A

NPO 6- 8 hours - undergo XRAY

Laxatives (Barium Sulfate) night before- for clearer visualization cleansing of enema

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2
Q

Expected stool output and for how many days after for Upper GI Series/ Barium Swallow

A

2-3 days of white stool

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3
Q

Position during Upper GI Series/ Barium Swallow

A

Standing/ Sitting

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4
Q

After procedure of Upper GI Series/ Barium Swallow; the patient will?

A

Increase fluid intake- to wash off the ingested drug

Use Laxatives (Barium Sulfate)- may constipate the patient and indicate that white stool is normal

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5
Q

For Upper GI Series/ Barium Swallow, it will help visualize the

A

Esophagus, Stomach, Duodenum, and Jejunum

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6
Q

BaSO4 for Upper GI Series/ Barium Swallow is administered through?

A

Mouth

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7
Q

Preparation for Lower GI Series/ Barium Enema

A

Low residue (low fiber)

NPO 6-8 hours

Clear liquid diet for 2 days

Laxatives night before

Cleansing enema in the morning of the test

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8
Q

After procedure of Lower GI Series/ Barium Enema, the nurse will?

A

Instruct the patient to increase fluid intake- to wash of ingested drug

Assess for signs of Barium Impaction

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9
Q

Signs of Barium Impaction

A

Distended Abdomen

Constipation

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10
Q

It is white chalky substance

A

Laxatives: Barium Sulfate (BaSO4)

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11
Q

For Lower GI Series/ Barium Enema, it will help visualize the?

A

Colon

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12
Q

For Lower GI Series/ Barium Enema, the BaSO4 is administered in?

A

Rectum

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13
Q

After care for Lower GI Series/ Barium Enema

A

same as UGIS

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14
Q

It is the direct visualization of esophagus, stomach and duodenum

A

Upper GI Endoscopy

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15
Q

Recommended Position for Upper GI Endoscopy

A

Semi-fowler

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16
Q

Preparation for Upper GI Endoscopy

A

Obtain written consent

NPO for 6-8 hours

Anticholinergic

Sedatives, narcotics, tranquilizers

Remove dentures, bridges

Local spray anesthetic (Lidocaine)

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17
Q

Anticholinergic drug indication

A

To reduce mucus secretions and prevent aspiration

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18
Q

Local spray anesthetic is administered to?

A

To depress gag reflex

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19
Q

For maximum effect of anesthetic, the nurse will?

A

Instruct the patient not to swallow saliva

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20
Q

We remove dentures, bridges to?

A

Prevent airway obstruction

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21
Q

after Upper GI Endoscopy, place the client in what position?

A

Side-lying

to prevent aspiration since pt is given anticholinergics

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22
Q

NPO until gag reflex return

A

to prevent aspiration

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23
Q

NSS gargle, throat lozenges

A

to soothe the throat

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24
Q

after Upper GI Endoscopy, assess pt if he/she have?

A

bleeding
crepitus (neck)
fever
neck/ throat pain
dyspnea
dysphagia
back/ shoulder pain

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25
Q

Lower GI Endoscopy (Proctosigmoidoscopy) only visualizes the

A

Sigmoid, Rectum

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26
Q

Preparation for Lower GI Endoscopy (Proctosigmoidoscopy)

A

Clear liquid diet 24 hours

Laxative

Cleansing enema

Intestinal evacuant like GoLytely in place of enema

Assess signs of Vasovagal stimulation since GI tract is supplied by the Vagus nerves

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27
Q

Position of pt during Lower GI Endoscopy

A

Knee-chest/ lateral position

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28
Q

Aftercare for Lower GI Endoscopy

A

Assess Signs of Anorectal Perforation-
Bleeding, Pain, and Fever

Hot Sitz Bath to relieve discomfort in anorectal area

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29
Q

Position of pt during Colonoscopy

A

Left sided, Knees Flexed

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30
Q

Preparation for Colonoscopy

A

same as proctoisigmoidoscopy

Sedatives

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31
Q

Aftercare for Colonoscopy

A

Monitor VS (note for vasovagal response- bradycardia, hypotension)

Assess signs and symptoms of perforation

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32
Q

Signs and Symptoms of Perforation

A

Bleeding, Pain, and Fever

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32
Q

Elevated levels indicate presence of colorectal cancer

A

Carcinoembryonic Antigen (CEA)

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33
Q

Indicates presence of malabsorption disorders.

A

D - xylose Absorption Test

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34
Q

for Fecal Analysis (Guaiac Stool Examination), instruct pt to

A

No red meats, poultry for 3 days before collection of stool specimen.

Withhold iron, steroids, NSAID’s for 48 hours
before collection of stool specimen as it may cause G.I. irritation

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35
Q

during Gastric Analysis, it collected every?

A

every 15 minutes to 1 hour

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36
Q

in Gastric Analysis, hypersecretion of HCl indicates?

A

duodenal ulcer or Zollinger- Ellison syndrome

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37
Q

in Gastric Analysis, decreased HCl secretion indicates?

A

gastric cancer or pernicious anemia.

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38
Q

Involves plain X-Ray of the abdomen

A

Scout Film of the Abdomen

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39
Q

Opening in the large intestines brought to the abdomen
stoma

A

Colostomy

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40
Q

Normal Color during Colostomy

A

Red and slightly edematous for 5-7 days

Pinkish red for the next few days

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41
Q

Abnormal color of Colostomy

A

Dark/brown (necrosis, ischemia)

Blanched (decrease circulation)

Dusk

Brownish black

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41
Q

Colostomy: Protruded or Prolapse?

A

Protruded

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41
Q

Normal Protrusion during Colostomy

A

½ to ¾

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41
Q

When will you empty pouch during Colostomy?

A

if it is 1/3 to ½ full

to prevent spillage of feces

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41
Q

Empty pouch with?

A

Weak vinegar solution

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42
Q

Which day will you expect flatus and fecal drainage for Colostomy?

A

4-7 days

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43
Q

during Colostomy Irrigation, position during bed rest?

A

Semi-fowlers

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44
Q

during Colostomy Irrigation, position during ambulatory?

A

Sitting on toilet or commode

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45
Q

Best time for Colostomy Irrigation

A

After meal

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46
Q

Height level of Colostomy Bag

A

12-18 inches above level of the shoulders

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47
Q

Solution for Colostomy Irrigation

A

500-1000 mL Warm NSS

Luke Warm Water

48
Q

time for better cleansing during Colostomy Irrigation

A

5-10 minutes

49
Q

drainage time during Colostomy Irrigation

A

12-20 minutes

50
Q

2-3 inches with forcing entry

A

If abnormal cramping occurs, clamp the tubing

51
Q

For the healed stoma, wash with during cleansing of skin?

A

Warm water and
soap

52
Q

For not healed stoma, wash with during cleansing of skin?

A

Antiseptic solution

53
Q

Food that increases odor

A

dairy product

highly seasoned food

cabbage

celery

54
Q

Foods that reduces odor

A

Yogurt

Parsley

Butter milk

55
Q

skin barrier / protect stoma from infection

A

Karaya paste

56
Q

indicates fungal infection (candida albicans)

A

White stoma

57
Q

What will you apply if you have fungal infection?

A

Nystatin powder

58
Q

Distance of stoma and emptying bag

A

1/16 - 1/8 inches

59
Q

Recommended position for Adult during Enema

A

Left lateral

60
Q

Recommended position for Infant/Child during Enema

A

Dorsal Recumbent

61
Q

Purposes of enema

A

Relieves constipation
Relieves gas
Administer med
Done prior to diagnostic / surgical procedure

62
Q

Recommended temperature for Enema

A

37.7°C (100°F)

too cold or too hot is uncomfortable and causes cramping.

63
Q

exert osmotic pressure, stimulates peristalsis and thus defecation.

A

Hypertonic Solution

64
Q

commonly used hypertonic enema

A

fleet phosphate enema

65
Q

hypertonic solution constituents

A

90-120 ml of solution

66
Q

hypertonic solution action

A

draws water into the colon

67
Q

hypertonic solution time to take effect

A

5-10 min

68
Q

exert a lower osmotic pressure causing water to move from the colon into the interstitial space.

A

Hypotonic solution (e.g. tap water)

69
Q

hypotonic solution constituents

A

500-1,000 ml of tap water

70
Q

hypotonic solution action

A

distends colon, stimulates peristalsis, and softens feces

71
Q

hypotonic solution time to take effect

A

15-20 min

72
Q

exert the same osmotic pressure, there is no fluid movement into or out of the colon.

A

Isotonic solution

73
Q

safest enema solutions to use

A

physiologic (normal) saline

74
Q

Isotonic solution constituents

A

500-1,000 ml of normal saline

75
Q

Isotonic solution action

A

distends colon, stimulates peristalsis, and softens feces.

76
Q

Isotonic solution time to take effect

A

15-20 min

77
Q

stimulate peristalsis by increasing the volume in the colon and irritating the mucosa.

A

Soapsuds enemas

78
Q

used in Soapsuds enemas in order to minimize irritation

A

only pure soap (i.e., Castile soap)

78
Q
A
79
Q

soapsuds constituents

A

500-1,000 ml (20 ml soap to 1.000 ml water)

80
Q

soapsuds action

A

irritates mucosa, distends colon

81
Q

soapsuds time to take effect

A

10-15 min

82
Q

Oil constituents

A

(mineral, olive, cottonseed) 160ml

83
Q

Oil action

A

lubricates the feces and the colonic mucosa

84
Q

Oil time to take effect

A

1-3 hr

85
Q

given to cleanse as much of the colon as possible.

A

High enema

86
Q

high enema amount of solution

A

1,000 ml

87
Q

height for high enema

A

18 inches

88
Q

position during high enema

A

client changes from the left lateral position to the dorsal recumbent position and then to the right lateral position

89
Q

used to clean the rectum and sigmoid colon only.

A

Low enema

90
Q

position during low enema

A

client maintains a left lateral position

91
Q

height for low enema

A

12 inches

92
Q

low enema amount of solution

A

500 ml

93
Q

introduces oil or medication into the rectum and sigmoid colon.

A

Retention enema

94
Q

time of retention enema

A

1 to 3 hrs

95
Q

retention enema action

A

acts to soften the feces and to lubricate the rectum and anal canal, thus facilitating passage of the feces

96
Q

temperature of solution for retention enema

A

105 to 110 F

97
Q

it is given primarily to expel flatus and to release tension or swelling in the colon and rectum

A

Carminative enema

98
Q

this type of enema allows wastes and toxins to leave the body.

A

Carminative enema

99
Q

also called a Harris flush

A

Return flow enema

100
Q

return flow constituents

A

100-200 ml of fluid

101
Q

repeated five or six times until the flatus is expelled and abdominal distention is relieved

A

Return flow enema

102
Q

Tap water solution

A

500-1000 ml of water

103
Q

Soapsuds solution

A

20ml castile soap in 500-1000ml

104
Q

NSS 9ml NaCI solution

A

1000ml

105
Q

Hypertonic solution / fleet enema solution

A

90-120 ml

106
Q

3 consecutive stool test to check for hidden (occult) blood in the stool

A

Guaiac Test

107
Q

route for TPN

A

subclavian vein – directly to Superior vena
cava

108
Q

alternate route for TPN

A

intrajugular vein

109
Q

position during insertion for TPN

A

Trendelenburg

To dilate the neck vein
Prevent air embolism
Dilate shoulder vein

110
Q

solution used for TPN

A

hypertonic

111
Q

Height of TPN solution

A

at least 12 inches above
the shoulders

112
Q

time to be consume for TPN

A

should be consumed for 24
hours only

113
Q

Use of insertion pump for TPN

A

to maintain a slow
administration to prevent hyperosmolar diuresis

114
Q

main IV changed for TPN is every?

A

every 24hrs

115
Q

How often to change the dressing for TPN

A

3x a week

116
Q

Position while dressing change for TPN

A

low fowler

117
Q

Solution for cleansing tubing for TPN

A

acetone then tincture of
iodine

118
Q

If interrupted / change out/ empty solution for TPN

A

change to d10 water temporarily to prevent hypoglycemia

119
Q

Expected weight gain for TPN

A

0.5 kg per day

120
Q

Position during NGT Insertion

A

High fowler

121
Q

Measurement during NGT Insertion

A

tip of the nose to the ear lobe to the xiphoid process + 6 in

122
Q

How to check NGT placement?

A

X-ray- most accurate

Aspirate gastric contents. Check pH (4.0 or lower)

Introduce air into NGT and auscultate epigastric area for gurgling sounds

123
Q

Position after procedure of Lower GI Endoscopy

A

Supine position

to prevent Orthostatic Hypotension

Gastrointestinal Procedures (1 decks)

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