MED SURG EXAM 2 - Review of the gastrointestinal disorders (including upper and lower GI disorders)

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UPPER GI DISORDERS (Ingestion & Digestion Disorders) CH. 46 + 47 GI SERIES ● Radiographic studies done with or without contrast that define anatomic or functional abnormalities o Upper GI Serie... s  an upper fluoroscopy delineates entire GI tract after introduction of a contrast agent  Enables examiner to detect/exclude anatomic or functional disorders of the upper GI organs or sphincters  Aids in DX of ulcers, varices, tumors, regional enteritis, and malabsorption syndromes  Procedure could be extended to examine the duodenum and small bowel o Barium Enema  for visualization of the lower GI tract ▪ Can be used to detect presence of polyps, tumors, or other lesions of the large intestine + demonstrate any anatomic abnormalities or malfxning of the bowel ▪ Contraindicated if: ● Pt has active inflammatory disease of colon (enemas contra) ● Signs of perforation or obstruction (a water-soluble contrast study would be done instead) ● Active GI bleeding (prohibits enemas + laxatives) ● Indications o Gastric ulcers, peristaltic disorders, tumors, varices, and intestinal enlargements or constrictions o C/O abdominal pain, altered elimination habits, or GI bleeding ● Nursing Actions o Pre procedure ▪ Upper GI Series: ● Dietary changes prior to study include: clear liquid diet, with NPO from midnight the night before the study ● Polyethylene glycol = most effective bowel cleansing prep agent ● No smoking, chewing gum, or mints b/c stimulates gastric motility ● Oral meds withheld the morning of the study, resumed that evening ▪ Barium Enema: ● Patient prep includes emptying + cleansing lower bowel ● Low-residue diet 1-2 days before the test ● Clear liquid diet and a laxative the night before the test ● NPO after midnight ● Cleansing enemas until returns are clear the morning of the test o Post procedure ▪ Upper GI series: ● Follow up to ensure the patient has eliminated most of the ingested barium ● Fluids may be increased to facilitate the elimination of stool + barium ▪ Barium Enema: ● Pt education  increase fluid intake, evaluate BMs for elimination of barium, note any increase in BMs (b/c barium has high osmolarity that may draw fluid into bowel, resulting in greater output) ENDOSCOPY ● Allows direct visualization of body cavities, tissues, and organs for diagnostic and therapeutic purposes ● Different Procedures o Esophagogastroduodenoscopy (EGD)  an be used to evaluate esophageal and gastric motility and to collect secretions and tissue specimens for further analysis ▪ Valuable when esophageal, gastric, or duodenal disorders or inflammatory, neoplastic, or infectious processes are suspected o Endoscopic Retrograde Cholangiopancreatography (ERCP)  uses the endoscope in combination with x-rays to view the ductal structures of the biliary tract ▪ Helpful in evaluating jaundice, pancreatitis, pancreatic tumors, common bile duct stones, and biliary tract disease o Colonoscopy  direct visualization of the large intestine (anus, rectum, sigmoid, transcending + ascending colon) ▪ Most frequently used for cancer screening + surveillance for those w/ previous colon cancer or polyps ▪ Also used in evaluation of pts with diarrhea of unknown cause, occult bleeding, or anemia, further study of abnormalities found w/ barium enemas, and DX/clarification of extent of inflammatory or other bowel disease [Show More]

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