LABS AND DIAGNOSTICS OF G.I

Question 1

The purpose of this test is to detect GI bleeding

Answer 1

Fecal- Occult Blood Test (FOBT)

Question 2

Patient Preparation when having Fecal- Occult Blood Test (FOBT)

Answer 2

• High fiber diet 48-72 hours
• Avoid red meat, poultry, turnips, horse radish, cauliflower, and melon (false positive result)
• Avoid vitamin C (false negative result)
• Hold 48 hrs prior; steroids, iron, indomethacin, colchicine

Question 3

Needs to avoid because this may give a false positive result

Answer 3

Avoid red meat, poultry, turnips, horse radish, cauliflower, and melon

Question 4

Needs to avoid because this may gave a false negative result

Answer 4

Avoid Vitamin C

Question 5

Needs to hold 48 hrs prior

Answer 5

-steroids
- iron
- indomethacin
- colchicine

Question 6

It’s purpose is to detect ova, parasites, and E. histolytica

Answer 6

Stool for Ova, Parasites and E. histolytica (OPEH)

Question 7

Specimen of OPEH

Answer 7

Fresh, warm stool via clean technique (send within 30 minutes of collection)

Question 8

This is to detect causative agent

Answer 8

Stool for culture and sensitivity

Question 9

Patient preparation of stool for culture and sensitivity

Answer 9

-may use clean gloves
- use sterile collection collection tube and sterile cotton- tipped applicator to collect specimen

Question 10

Sterile stool specimen

Answer 10

Stool for culture and sensitivity

Question 11

Its purpose is to detect enlargement of gallbladder, pancreas, presence of gallstones, ectopic pregnancy, appendicitis

Answer 11

Abdominal Ultrasound

Question 12

Patient Preparation for Abdominal Ultrasound

Answer 12

• NPO for 8 to 12 hours
• Laxatives, as ordered
• If for gallbladder studies, fat-free meal the evening before
• Schedule barium studies after ultrasonography since barium interferes with sound wave transmission

Question 13

It’s purpose is to provide a contrast-enhanced radiologic image of the espohagus, stomach, duodenum, and jejunum

Answer 13

Upper G.I Studies (Barium Swallow)

Question 14

Contrast Medium of Barium Swallow

Answer 14

Barium Sulfate

Question 15

white, chalky substance

Answer 15

Barium Sulfate (PO)

Question 16

Patient Preparation for Barium Swallow

Answer 16

NPO for 6 to 8 hours

Question 17

What interventions do we need to do after the procedure of Barium Swallow

Answer 17

-Increase oral fluid intake
- Laxatives, as ordered
- Inform patient that stool may become white 24-72 hours

Question 18

It’s purpose is to provide a contrast- enhanced radiologic image of the colon

Answer 18

Lower G.I studies (Barium Enema)

Question 19

Contrast medium of Barium Enema

Answer 19

Barium Sulfate (enema)

Question 20

Contraindication of Barium Enema

Answer 20

-Contraindicated for patients with active inflammatory diseases, fistula, or suspected perforation of colon
- Diatrizoic Acid is used instead

Question 21

It is a water soluble iodinated contrast medium

Answer 21

Diatrizoic acid

Question 22

Patient Preparation for Barium Enema

Answer 22

• Low residue diet 1 to 2 days before
• Clear liquid diet and laxative the evening before
• NPO pos-midnight
• Cleansing enema until clear in AM of procedure
• Schedule before any upper GI studies

Question 23

It’s purpose is to provide direct visualization of esophagus, stomach, and duodenum

Answer 23

Upper G.I Endoscopy

Question 24

Patient Preparation for Upper G.I Endoscopy

Answer 24

• Obtain written consent
• NPO 6-8 hours
• Administer Atropine Sulfate, as ordered
• Administer sedatives/narcotics/tranquilizers, as ordered
• Remove dentures or bridges
• Lidocaine spray is applied to the posterior pharynx to depress gag reflex
• Instruct not to swallow saliva

Question 25

Post Procedure Care of Upper G.I Endoscopy

Answer 25

• Position to side-lying preparation
• NPO until gag reflex returns
• NSS gargle
• Monitor V/S
• Assess: bleeding, crepitus, fever, neck/throat pain, dyspnea, dysphagia, back/shoulder pain

Question 26

Direct visualization of the colon

Answer 26

Colonoscopy

Question 27

Direct visualization of sigmoid and rectum

Answer 27

Proctosigmoidoscopy

Question 28

Patient Preparation for Lower G.I Endoscopy

Answer 28

-Obtain written consent
- Clear liquid diet 24 hours before procedure
- Administer laxative/cathartic, as ordered
- Cleansing enema until clear
- Position to knee-chest/lateral position during procedure
- Assess for vasovagal stimulation

Question 29

Post- Procedure Care of Lower G.I Endoscopy

Answer 29

-Position to supine for a few minutes
- Assess for signs of perforation (bleeding, pain, fever)
- Hot sitz bath to relieve discomfort in anorectal area

Question 30

What is the side effects of Barium Sulfate?

Answer 30

Constipation

Question 31

Preferred way of enteral feeding for nutritional support of greater than 4 weeks

Answer 31

Gastrostomy

Question 32

Indicated when gastric route is not accessible, or to decrease aspiration risk when stomach is not functioning adequately to process and empty food or fluids

Answer 32

Jejunostomy

Question 33

Enteral Feeding

Answer 33

Feeding should be at ROOM temperature
Position: semi- to high- fowler’s position
Check patency: Instill 15 to 30 ml of water
Have the client remain in semi- to high- fowler’s position for 30 to 60 mins after feeding