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19 Cards in this Set
- Front
- Back
Upper GI - Barium swallow
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-x ray study
-uses contrast medium -dx structural abnormality of esophagus and stomach |
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barium swallow: nursing responsibility
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-contrast medium
-NPO 8-12 hrs before -no smoking after midnight -after, prevent impaction (laxatives, push fluids) -stool may be white 72hrs after |
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Lower GI - barium enema
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same as swallow, but rectal.
air infused after barium evacuated |
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barium enema: nursing responsibility
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-clear bowel before (laxatives, enema)
-clear liquid diet prior -NPO 8 hr before -cramping/urge to defecate may occur -after, push fluids, laxatives -observe stool (passage of medium) |
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abdominal ultrasound
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detects masses, assesses ascites
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abd ultrasound: nursing
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bowel must be clean
explain procedure |
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colonoscopy
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-visualizes whole colon
-fiberoptic scope -pt position changed during procedure -dx IBD, detect tumors, dilate strictures -removal of colonic polyps |
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colonoscopy: nursing
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-NPO 8 hrs, clear liquid diet 1-3 days
-laxatives 1-3 days before, enemas night before -sedation given -alternate 1 gal Goltely or Colyte before -after, cramping -check vitals -check for rectal bleeding (malaise, distention) |
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Esophagogastroduodenoscopy (EGD)
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visualize upper GI. may look at stomach motility, inflammation, ulcerations, tumors, varices, Mallory-Weiss tear
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EGD: nursing
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-NPO 8 hr
-signed consent -pre-op med maybe (diazepam...) -explain local anesthetic (throat) and sedation -**after, NPO until gag reflex returns**, warm saline gargle -check temp q 15-30min for 1-2 hr |
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Endoscopic retrograde cholangiopancreatography (ERCP)
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-endoscope orally to descending duodenum, bile/pancreatic ducts
-contrast medium -visualizes structures -can retrieve gallstones, dilate structures, biopsy tumors |
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ERCP: nursing
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-NPO 8 hrs
-consent form -sedative -antibiotics if ordered -after, check vitals, sign of perforation, infection *pancreatitis most common complication -check return of gag reflex |
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Gastric analysis
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-acidity and volume
-NG tube, aspiration fasting Normal acidity: 2.5 fasting normal vol: 62 ml/hr -histalog and pentagastrin can speed it up *NPO 8-12 hr *withhold drugs affecting gastric secretion 24-48 hr *no smoking that morning |
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serum amylase
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-secretion of amylase by pancreas (dx acute pancreatitis)
-peaks in 24 hr then drops *collect blood sample in acute pancreatitis attack normal = 0-130 |
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serum lipase
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-secretion of lipase from pancreas
-stays elevated longer than amylase normal = 0-160 |
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fecal analysis
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form, consistency, color
checks for blood, pus, mucus, parasites, fat occult blood (guaiac, hemoccult, hematest) *diet free of red mean 24-48 hr before |
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liver biopsy
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-invasive
Nursing: -check coagg. (PT) -type/crossmatch -vitals for baseline -pt holds breath after expiration w/ needle insertion -after, vitals q15min x 2 -lying on rt side 2 hrs -lying flat 12-14 hr -watch for bile peritonitis, shock, pneumothorax |
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dehydration labs
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increased BUN
normal creatinine |
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liver palpation technique
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left hand behind the back (11th & 12th ribs)
rt hand on pts rt abdomen lateral to rectus muscle pt takes a deep breath |