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    Barium Enema

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    arturogarcesjr
    The document discusses various gastrointestinal diagnostic procedures and tests including barium enema, ultrasonography, endoscopic procedures, nasogastric/nasointestinal tube insertion, and total parenteral nutrition. It provides details on the purposes, processes, nursing considerations, and potential complications for each procedure.

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    Barium Enema

    Uploaded by

    arturogarcesjr
    493 views5 pages
    The document discusses various gastrointestinal diagnostic procedures and tests including barium enema, ultrasonography, endoscopic procedures, nasogastric/nasointestinal tube insertion, and total parenteral nutrition. It provides details on the purposes, processes, nursing considerations, and potential complications for each procedure.

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    The document discusses various gastrointestinal diagnostic procedures and tests including barium enema, ultrasonography, endoscopic procedures, nasogastric/nasointestinal tube insertion, and total parenteral nutrition. It provides details on the purposes, processes, nursing considerations, and potential complications for each procedure.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    493 views5 pages

    Barium Enema

    Uploaded by

    arturogarcesjr
    The document discusses various gastrointestinal diagnostic procedures and tests including barium enema, ultrasonography, endoscopic procedures, nasogastric/nasointestinal tube insertion, and total parenteral nutrition. It provides details on the purposes, processes, nursing considerations, and potential complications for each procedure.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 5

    BARIUM ENEMA

    • Fluoroscopic x-ray examination visualizing the entire large intestine is


    administered after rectal instillation of barium SO4

    • detects structural changes, such as tumors, polyps, diverticula, fistulas,


    obstructions, and ulcerative colitis

    • Air may be introduced after the barium to provide a double-contrast study

    NURSING AND PATIENT CARE CONSIDERATIONS

    • Explain the procedure to the patient

    • NPO after midnight the day of procedure

    • enema or cathartic may be ordered after the barium enema

    • barium may cause light-colored stools for several days after the procedure

    PURPOSES OF ENEMA ADMINISTRATION

    • 1. Bowel preparation for diagnostic tests or surgery to empty the bowel of


    fecal content.

    • 2. Delivery of medication into the colon ( such as enemas containing


    neomycin to decrease the bowel’s bacteria count or a kayexalate enema
    to decrease the serum potassium level)

    • 3. To soften the stool ( oil-retention enemas)

    • 4. To relieve gas( tidal,milk and molasses,or fleet enemas)

    • 5. Promote defecation and evacuate feces from the colon for patients with
    constipation or an impaction.

    ULTRASONOGRAPHY

    • focuses high-frequency sound waves over an abdominal organ to obtain


    an image of the structure

    • detect small abdominal masses, fluid-filled cysts, gallstones, dilated bile


    ducts, ascites, and vascular abnormalities

    • Ultrasound with Doppler may be ordered for vascular assessment

    NURSING AND PATIENT CARE CONSIDERATIONS

    • special diet, laxative, or other medication to cleanse the bowel


    and decrease gas

    • NPO for at least 6 hours before the procedure


    • Change position of patient, as indicated, for better visualization
    of certain organs

    ENDOSCOPIC PROCEDURES
    • to visualize the GI tract and to perform certain diagnostic and therapeutic
    procedures

    • Images are produced through a video screen or telescopic eyepiece

    • can be inserted through the rectum or mouth, depending on which portion


    of the GI tract is to be viewed

    • Can also be used for biopsy or cytology of lesions, removal of foreign


    objects or polyps, control of internal bleeding, and opening of strictures

    ESOPHAGOGASTRODUODENOSCOPY (EGD)

    • visualization of the esophagus, stomach, and duodenum

    • diagnose acute or chronic upper GI bleeding, esophageal or gastric


    varices, polyps, malignancy, and gastroesophageal reflux

    • can be used to perform a biopsy or cytologic study, remove polyps or


    foreign bodies, control bleeding, or open strictures

    NURSING AND PATIENT CARE CONSIDERATIONS

    • Explain the procedure

    • NPO for 8 to 12 hours before the procedure to prevent aspiration and allow
    for complete visualization of the stomach

    • Remove dentures and partial plates to facilitate passing the scope and
    preventing injury

    • Inform the health care provider of any known allergies and current
    medications. Medications may be held until the test is completed

    • Obtain prior x-rays, and send with the patient

    • Local anesthesia is administered along with midazolam

    • Keep patient NPO according to protocol until patient is alert and gag reflex
    has returned

    • May resume regular diet after gag reflex returns and tolerating fluids
    • May experience a sore throat for 24 to 36 hours after the procedure. When
    the gag reflex has returned, throat lozenges or warm saline gargles may
    be prescribed for comfort

    • Possible complications:

    • perforation of the esophagus or stomach

    • pulmonary aspiration

    • hemorrhage

    • respiratory depression or arrest

    • infection

    • cardiac arrhythmias or arrest

    PROCTOSIGMOIDOSCOPY AND COLONOSCOPY

    • Proctosigmoidoscopy is the visualization of the anal canal, rectum, and


    sigmoid colon through a fiberoptic sigmoidoscope

    • Colonoscopy is the visualization of the entire large intestine, sigmoid


    colon, rectum, and anal canal

    • used to diagnose malignancy, polyps, inflammation, or strictures

    • Colonoscopy is used for surveillance in patients with a history of chronic


    ulcerative colitis, previous colon cancer, or colon polyps

    • Position: lying left side with the knees drawn up to the chest

    • Lower GI endoscopy can be used to perform biopsy, remove foreign


    objects, or obtain specimen for culture or cytology

    • Colonoscopy, a more extensive procedure than proctosigmoidoscopy,


    requires several days of bowel preparation and use of conscious sedation
    during the procedure

    • bowel preparation:

    • 1 gallon or less iso-osmolar electrolyte solution to consume over a


    3- to 4-hour period the day before the procedure

    • clear liquid diet the day before the procedure

    • oral laxative the night before the procedure.

    NURSING CARE:
    • NPO after midnight

    • Clear liquid diet at noon a day before the test

    • Observe the patient for a change in vital signs, bleeding, pain, vomiting,
    abdominal distention or rigidity

    • Ensure that patients who have had endoscopic procedures requiring


    sedation have a caregiver to drive home after the procedure

    NASOGASTRIC AND NASOINTESTINAL INSERTION

    • Nasogastric insertion refers to the insertion of a tube through the


    nasopharynx into the stomach.

    • Nasointestinal insertion is performed by inserting a small-bore tube,


    that is carried by way of peristalsis into the duodenum or jejunum

    • used for intestinal decompression, administering feedings and


    maintaining nutritional intake

    PURPOSES OF NASOGASTRIC INSERTION

    • Remove fluid and gas from the stomach (decompression)

    • Prevent or relieve nausea and vomiting after surgery or traumatic events

    • Determine the amount of pressure and motor activity in the GI tract

    • Irrigate the stomach (lavage) for active bleeding or poisoning

    TOTAL PARENTERAL NUTRITION

    • administered to meet a client’s total nutritional needs when oral


    feedings,tube feedings, and standard IV feedings are contraindicated

    • used for client’s with various GI problems or other conditions that


    necessitate nutritional support such as some oncology clients

    IMPORTANT POINTS:

    • administer TPN through a central vein such as subclavian

    • Administer TPN at a constant rate

    • The infusion should never be stopped abruptly

    • Administer dextrose 10% in water if you must stop the infusion

    • In TPN administration, the pancreas secretes increased insulin; abrupt


    cessation can cause hypoglycemia
    • Maintain strict asepsis

    • Monitor blood glucose levels or check urine for glucose every 6 hours

    • Observe the client for headache, nausea, vomiting and fever, indicate an
    allergy to the protein

    • Closely monitor intake and output

    • Weigh the client daily (1/4 lb per day)

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