Large Ba enema

Question 1

why might you choose CO2 over room air for a negative contrast

Answer 1

more rapidly absorbed than nitrogen in room air, produces less cramping

Question 2

intussusception

Answer 2

part of the intestine slides into another part of the intestine

Question 3

volvulus

Answer 3

loop of intestine twists around itself and supplying mesentery, causing obstruction

Question 4

diverticulosis vs, diverticulitis

Answer 4

diverticulosis - presence of small punches in tract
diverticulitis - inflammation or infection of said puches

Question 5

hirschsprung’s disease

Answer 5

birth defect means missing nerves in large intestine, causing constipation

Question 6

Ba large intestine contraindications (5)

Answer 6

perforation / obstruction
prior to surg
bowel biopsy in past 24h
pelvic irritation
poor preparations

Question 7

what is the scout image in a small bowel study for

Answer 7

assess gross anatomy
check for stool (absolutely cannot have!)

Question 8

what diet is followed for a small bowel prep

Answer 8

low residue diet for 3 days prior t

Question 9

what is the rule 24h before small bowel imaging

Answer 9

fluids only + laxative

Question 10

what are some examples of pre imaging laxatives

Answer 10

Citro-mag, PEG, PICOLAX

Question 11

what preparations are done for small bowel imaging of infants

Answer 11

none!!

Question 12

contraindications for small bowel PREP laxatives (4)

Answer 12

gross bleeding
severe diarrhea
known obstruction
inflammatory conditions

Question 13

what disease may require specific instructions when imaging small bowel

Answer 13

insulin-dependant diabetes mellitus and non insulin diabetes mellitus

Question 14

what do anticholinergic drugs do

Answer 14

reduce motility
relieve spasms, allowing bowel to expand

Question 15

what antocholinergic drugs are used

Answer 15

buscopan or glucagon

Question 16

what are the contraindications for anticholinergic drugs

Answer 16

cardiac disease and glaucoma

Question 17

what is glucagon used as for imaging

Answer 17

an antispasmotic

Question 18

when is glucagon used for imaging

Answer 18

is pt has a contraindication to buscopan

Question 19

what is a contraindication for glucagon

Answer 19

diabetes

Question 20

how much glucagon is given for imaging

Answer 20

1mg, intravenously

Question 21

what must ALWAYS happen before removing the enema tip

Answer 21

deflate the cuff

Question 22

what are the temperatures for warm and cold barium

Answer 22

5 deg cold, 29-30 warm

Question 23

why would you use cold Ba

Answer 23

mild anesthetic, easier to retain

Question 24

why might you use warm Ba

Answer 24

maximum pt comfort

Question 25

how much air is used to inflate the balloon

Answer 25

90 mL, 1 squeeze

Question 26

when might you use a Foley catheter instead? (3)

Answer 26

severe hemorrhoids, fissures, stricture

Question 27

what are enema tip insertion steps 1-5

Answer 27

1. check retention balloon 2. describe procedure 3. pt in Sims position 4. mix suspension, fill tube and clamp 5. coat tip with lubricant

Question 28

what are enema tip insertion steps 6-9

Answer 28

6. on exp, direct anteriorly 7. advance sup, up to 4" 8. may tape, inflate when directed 9. ensure bag is no more than 24" above table, clamp is closed (no flow)

Question 29

what is the bag height safety concern

Answer 29

should NEVER exceed 24" above level of anus

Question 30

what is the single contrast small bowel technique (4)

Answer 30

scout (80-85kVp) Ba runs, spot images overhead views post evac imaging

Question 31

how is a 2 stage air-contrast barium enema done? (4)

Answer 31

Ba until splenic air to push right Ba emptied Fill with air

Question 32

where is the CP for AP/PA small bowel

Answer 32

iliac crests