Barium Swallow
What is the Barium Swallow?
It's an upper gi test to look for many disorders
What can you detect in a Colonoscopy?
Tumors, polyps, inflammation, ulcers, and bleeding. You can also do biopsies.
What does an EGD do?
Gives you a direct visualization of the esophagus, stomach and duodenum through lighted endoscope.
What are NG tubes used for?
Helps decompress the stomach
what is TPN and PPN?
Nutrition through a central line for pt that need nutrition
It's done by the pt ingesting a contrast, which can be barium sulfate or gastrografin, and then x-rays are taken as the pt lays in different positions.
What to do Pre-op?
You need consent, a complete bowel prep (Mag citrate, golytely), clear liquid day before and then NPO, fleets enema given prior, and avoid asprins/NSAIDS
If a pt has a ng tube, what should you do before you listen to their bowel sounds?
Turn off suction
How do you check if the NG tube is placed right?
You can check the pH of the acid to see if it's acidic, can get an x-ray for placement, and can push air in to hear if it's in the stomach.
Why would someone need TPN or PPN?
Any conditions that affect the ability to digest or absorb nutrients like Crohn's or pancreatitis. Also if someone needs to rest their digestive system after a major surgery.
what to do pre-op?
Have pt be NPO at least 8 hrs before, may be given laxatives prior to procedure, and may hold anticholinergics and opioids.
What to do Post-op?
Monitor for perforated bowel (abdominal tenderness, rigidity, distention), monitor for flatus, assess for bleeding if polyp is removed
What does hypoactive, hyperactive and absent bowel sounds mean?
Hypoactive: medications, anesthesia, radiation, and surgery
Hyperactive: Diarrhea, Crohn's/UC, GI bleed
Absent: peritonitis, shock, ileus
What is a common complication for internal feedings?
Diarrhea is common for these pt and can aspirate.
What are nursing considerations for TPN?
Keep refrigerated until used, always on iv bump with filtered tubing, check BSG 4-6 hrs, DW, assess labs, no abrupt change in rate and D/C slowly, and monitor I&O.
What to do post-op?
Teach the pt that stool may be light color due to barium contrast, increase fluids for a few days after, may be give MOM to help prevent constipation and bowel obstruction, monitor bowel elimination (barium- constipation, Gastrografin- diarrhea).
What is a stool guaiac?
It's a fecal specimen examined for occult blood
What can you find with an EGD?
Detects mucosal inflammation (GERD and gastritis), tumors, varices, hiatal hernia, polyps, ulcers and obstructions. Can also do biopsies this way.
What should you do before you start feeding?
Follow policy, always check placement, check residual if less than 100, hold feeding; reinstall aspirated amount, HOB always up for feed, change tubing every 24 hrs and only put room temp and only enough feed in for 4 hrs each time.
What one is used for a short term?
PPN
What can be diagnosed with a barium swallow?
Cancers, ulcers, GERD, varices, obstructions, hiatal hernia, problems with swallowing, and problems that cause narrowing of the esophagus.
What does a stool sample test for?
Fat, clostridium difficile toxin, cultured for bacteria, virus, or parasities
What should we do for pre-op and post-op?
Pre-op: NPO at least 8 hrs before, consent, stop taking NSAIDS and aspirin 5 days before, and if on coumadin, will need PT and INR.
Post-op: NPO until alert and gag reflux is intact, VS, airway, bleeding, chest pain