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Chapter 13 Review
Patient care during gastrointestinal radiographic procedures
93
Health Care
Not Applicable
06/19/2012

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Term
The development of undesired side effects or toxicity caused by the administration of drugs.
Definition
Adverse effects
Term
The organs of digestion; the digestive tract.
Definition
Alimentary canal
Term
An artificial opening (stoma) created in the large intestine and brought to the surface of the abdomen for the purpose of evacuating the bowels.
Definition
Colostomy
Term
Inflammation of a sac or pouch protruding from the walls of the intestines, especially the colon.
Definition
Diverticulitis
Term
Gas expelled from the digestive tract through the anus.
Definition
Flatus
Term
An artificial opening (stoma) erected in the small intestine (ileum) and brought to the surface for the purpose of evacuating feces.
Definition
Ileostomy
Term
A thin tube that is inserted through the nose and into the stomach for the purpose of instilling substances or for the removal of substances.
Definition
Nasogastric tube (NG tube)
Term
General term for an operation in which an artificial opening is formed.
Definition
Ostomy
Term
Inflammation of the serous membrane lining the abdominal cavity and surrounding the abdominal organs.
Definition
Peritonitis
Term
An opening in the body created by bringing a loop of bowel to the skin surface.
Definition
Stoma
Term
When imaging of the GI tract using barium is contraindicated, an _________ contrast agent may be prescribed.
Definition
iodinated
Term
What are the two types of radiographic contrast agents?
Definition
1. Negative
2. Positive
Term
________ contrast agents decrease organ density to produce contrast.
Definition
Negative
Term
What are the most commonly used negative contrast agents? (2)
Definition
1. CO2
2. O2
Term
________ contrast agents are used to increase organ density and improve radiographic visualization.
Definition
Positive
Term
What are the positive radiographic contrast agents? (2)
Definition
1. barium sulfate
2. iodinated preparations
Term
A complication that is associated with the use of negative contrast agents can result from inadverent injection of air into the bloodstream, producing an air _______.
Definition
embolus
Term
(True or False) By using double contrast of barium and air, the ability to detect small lesions is improved.
Definition
True
Term
If barium leaks into the peritoneal cavity, an adverse effect known as ___________ may result.
Definition
peritonitis
Term
When perforation of the GI tract is suspected, what contrast medium will probably be used?
Definition
An absorbable, water-soluble iodinated contrast medium in place of barium sulfate will be used.
Term
Lower GI prep for infant - 2 yrs of age?
Definition
No prep necessary
Term
Lower GI prep for 3 yrs - 10 yrs?
Definition
Low residue meal the evening before
Term
Lower GI prep for adult patients?
Definition
Low residue foods 2-3 days prior to procedure, increased fluid intake 2-3 days prior to procedure, clear liquid diet 24 hrs prior to procedure, instruct pt to drink five 8 oz glasses of water/clear liquids during the prior 24 hrs, the afternoon preceding the exam - take 10 ounces magnesium citrate, the evening before the exam, another laxative may be ordered, and cleansing enema the night before or early morning of exam
Term
(True or False) Laxatives may be given to the pt without a physician's order.
Definition
False; physician's order is necessary
Term
(True or False) The type of cleansing enema is always ordered by the physician.
Definition
True
Term
____________ fluids can create dehydration.
Definition
Hyperosmolar
Term
___________ fluids can create fluid toxicity.
Definition
Hypo-osmolar
Term
What is the only type of cleansing enema that is safe to use on infants, children, and elderly patients?
Definition
normal saline enemas
Term
What about normal saline enema fluid makes it safe to use on infants, children, and elderly patients?
Definition
It has the same osmolarity as that in the interstitial spaces that surround the colon; therefore, it will not change the fluid balance in the body. Infants, children, and the elderly can tolerate very little change in electrolyte balance.
Term
UGI prep:
Definition
Low residue diet 2-3 days prior, NPO 8 hours before study
Term
Approximately how many ounces of barium is used for an Upper GI study?
Definition
14-16 oz
Term
What type of barium suspension is used for an Upper GI study?
Definition
Thick or thin
Term
What is used to produce double contrast in an Upper GI w/ air?
Definition
1. C02 crystals and water
2. Soda (kids)
Term
What is the purpose of a double contrast Upper GI?
Definition
To better visualize the mucosal lining
Term
What is an enteroclysis?
Definition
It is a small bowel enema.
Term
In an enteroclysis, the contrast is admistered through an (NG/NE) tube.
Definition
NE (Nasoenteric) tube
Term
What is the purpose of an enteroclysis?
Definition
To vizualize the entire small bowel
Term
In an enteroclysis, what is administered through the NE tube?
Definition
Barium and methylcellulose
Term
What type of contrast is used in a cholecystography?
Definition
Orografin
Term
Cholecystograms are now done mostly in what modalities?
Definition
US (most common modality used), MRI, Nuc Med, CT, and Specials
Term
What are the different types of cleansing enemas? (5)
Definition
1. Saline
2. Hypertonic
3. Oil retention
4. Tap water
5. SS (Soap Suds)
Term
Why are scout KUBs taken to prepare for a barium enema? (6)
Definition
1. Free fluid in the abd 2. Air outside the bowel (free air) 3. Air inside the bowel 4. Unusual densities 5. Size and shape of organs 6. Abdominal aortic aneurysm
Term
Barium is inert. What does this mean?
Definition
It means that it will not interact with bodily tissues.
Term
If an upright abd shows air below the diaphragm, what could this possibly mean?
Definition
The pt could have a perforation in their colon.
Term
What is lavage?
Definition
SX to clean barium out of peritoneal cavity
Term
What are 4 adverse reactions a pt may have to glucagon?
Definition
1. nausea 2. vomiting 3. hives 4. flushing
Term
What does glucagon do?
Definition
It relaxes the smooth muscle and prevents cramping (relaxes colon for barium enema).
Term
How much contrast media is needed for a single contrast barium enema?
Definition
1,500 ml
Term
The barium enema bag should be hung ______ than the table.
Definition
higher
Term
BE - Insert the tip _-_ inches.
Definition
3-4 inches
Term
How much contrast media is needed for a double contrast barium enema?
Definition
300-500 ml
Term
(True or False) Barium is more diluted for pediatric BE pts and less barium is used.
Definition
True
Term
Do not use the inflatable cuff on what type of BE pts?
Definition
pediatric pts
Term
What should be used in place of plain enema tips for infants?
Definition
10F or 12F (Foley catheter)
Term
Is (more/less) barium used for colostomy barium enemas?
Definition
less
Term
Use the ____ shaped tip for colostomy BEs.
Definition
cone
Term
Never place a stoma pt in the _____ position.
Definition
prone
Term
If a pt is constipated after barium studies, what should they do?
Definition
Tell them to contact their physician.
Term
Don't instruct a pt to drink 'a lot' of water for a GI exam or preceding a GI exam if s/he has what 2 problems?
Definition
1. CHF
2. Kidney Failure
Term
What are the 5 methods of administering barium?
Definition
1. Per os
2. Rectal
3. Stoma
4. NG (nasogastric) tube "thru nose into stomach"
5. NE (nasoenteric) tube "thru nose into duodenum"
Term
What type of contrast is ordinarily used for swallowing studies?
Definition
esophotrast
Term
Explain how to take overheads for an esophagram.
Definition
Tell pt to drink 5-6 steady swallows of contrast medium, take a collimated image of the barium-filled esophagus (collimator should be 6-8 inches open in width).
Term
Barium contrast should take no more than __ hrs to reach the colon.
Definition
24
Term
Iodinated contrast should take no more than _ hrs to reach the colon.
Definition
4
Term
"SBFT" stands for:
Definition
Small Bowel Follow Through
Term
When will a pneumatic compression paddle most likely be used?
Definition
During UGIs and SBFTs
Term
__________ enemas cannot be done on children and the elderly.
Definition
Hypertonic
Term
What can you add to a tap water enema to prevent children from developing fluid toxicity?
Definition
saline solution
Term
What should the temperature of the barium be for BEs?
Definition
85-90 degrees F (Warm, but less than body temp)
Term
Single contrast BEs use __%-__% W/V.
Definition
12%-25% W/V
Term
Double contrast BEs use __%-__% W/V.
Definition
75%-95% W/V
Term
PO barium should be (warm/cold).
Definition
cold
Term
Glucagon increases blood sugar levels. Do not give glucagon to what type of pt?
Definition
The diabetic pt
Term
Urinating more than 2.5 L a day is excessive urination - also know as:
Definition
polyuria
Term
Waking up at night frequently to urinate is known as:
Definition
nocturia
Term
A Pneumatic Compression Paddle will usually be used during what fluoro exams?
Definition
Small Bowel and UGI
Term
If the Radiologist suspects that a pt has peforation of the bowel what contrast agent should be used in place of barium?
Definition
Gastrografin
Term
A nasoenteric tube is inserted into the _________.
Definition
duodenum
Term
Enteroclysis is a fancy word for what?
Definition
a Small Bowel Enema
Term
An oil retention enema should be held for how much time before it is expelled?
Definition
1 hour
Term
________ _______ is used as a laxative to cleanse the bowel before a Barium Enema.
Definition
Magnesium Citrate
Term
Large distended gas and fluid filled loops of colon viewed on the image could be an indication of what?
Definition
An obstruction of the colon
Term
(True or False) Children 3-10 years do not require instructions for prep before a BE.
Definition
False
Term
Fluid from the cells pours into the colon when a __________ fluid is inserted into the lower bowel.
Definition
hyperosmolar
Term
Methylcellulose is used for an ____________.
Definition
enteroclysis
Term
Place these exams in the order in which they should be scheduled: 1. IVP 2. BE 3. Lumbar Spine 4. Thyroid Scan
Definition

1. Thyroid Scan

2. L-Spine

3. IVP

4. BE

Term
A pt who has been given glucagon during a GI exam must be observed for what amount of time after the exam?
Definition
30 minutes
Term
What is the quantity of barium needed for a UGI?
Definition
12 oz
Term
What type of cleansing enema can be given to an elderly pt to relieve fecal impaction?
Definition
Oil retention enema
Term
If you cannot insert the tip for a BE because of some resistance you should do what?
Definition
Stop and ask the Radiologist to insert the tip
Term
Oral administration and nasoenteric tubes are methods of admistering the contrast medium for examination of the _____ ______.
Definition
small bowel
Term
(True or False) Administration of hypo-osmolar fluids for an enema can create fluid toxicity.
Definition
True
Term
The BE bag should be hung __ inches higher than the table.
Definition
30
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