Day 3 Lecture - GI and Nutrition
Day 3 Lecture - GI and Nutrition
Day 3 Lecture - GI and Nutrition
▪ Double Contrast
▪ Thick Barium – 200% w/v to 250% w/v
▪ 15 ml to 20 ml
▪ Low fiber diet 2-3 days before the test
▪ NPO (food or fluids) for 6 – 8 hours before test
▪ Instruct client about procedure and barium
preparation.
▪ Barium has thick consistency and chalky taste
▪ Drink up to 16 ounces of barium for the
procedure
▪ Test last about 45 minutes
▪Laxative is given to help expel the barium
and prevent fecal impaction.
▪Assess abdomen for distention and observe
stool to determine whether barium has been
eliminated.
▪Initially stool is white, but should return to
normal brown color within 72 hours
▪A distended abdomen and constipation may
indicate barium impaction.
▪Client with ostomies should be closely
monitored for retained barium.
▪Because the barium swallow is commonly
performed on an outpatient basis, inform the
client that the stool maybe white for up to 72
hours after the procedure.
▪Contact physician immediately if constipation
and abdominal distention occur.
▪ Also known as videofluoroscopy or an
oropharyngeal motility study, is performed to
assess swallowing and the risk of aspiration.
▪ Client sitting in a chair equipped with
videofluoroscopy
▪ Asked to swallow small amount of barium mixed in
liquids and foods of various textures.
▪ During the procedure, a speech therapists or
radiologist observes the client for difficulty with
swallowing.
▪Clients are maintained on NPO status before
the procedure.
▪Maintain hydration with intravenous fluids if
client is expected to remain NPO for an
extended period.
▪Nothing should be ingested by mouth until
the speech therapist, radiologist or physician
has evaluated the test results.
▪If diet alterations, consult a registered
dietitian, speech therapist, or both to be
collaboratively develop an appropriate and
adequate nutrition plan.
▪It is administered for the radiographic
animation (with or without fluoroscopy) of the
large intestine.
▪Barium sulfate (single-contrast technique)
or Barium sulfate and air (double contrast
technique) are instilled rectally.
▪The test is indicated for clients with a history
of altered bowel habits; lower abdominal
pain; or passage of blood, mucus, or pus in
the stools.
▪The test helps to detect tumors, diverticula,
stenoses, obstructions, inflammation,
ulcerative colitis and polyps.
▪ Adequate preparation is essential
▪ Low residue or clear liquid diet for 2 days
before the test to reduce feces volume.
▪ Potent laxative and oral liquid preparation is
given for cleaning the bowel the day before the
test.
▪ NPO (nil per os, nothing by mouth) after
midnight
▪ The morning of examination, a suppository or
cleansing enema may be administered.
▪ If active bleeding or an ileostomy, different bowel
preparations may be needed.
▪ If ultrasonography, abdominal scan or
colonoscopy is also indicated, it should be
performed first because barium interferes with
these tests.
▪ Duration of procedure: 60 – 90 minutes,
uncomfortable
▪ Barium impaction is a serious complication after
lower GI series.
▪ Laxative or cleansing enema is often given after
the test to empty the large bowel.
▪ Stools are white for 24 – 72 hours after the
examination.
▪ Encourage increase fluid intake to prevent fecal
impaction
▪ Instruct to report any pain, bloating or absence of
stool or bleeding.
▪It is an x-ray (radiograph) of the abdominal
organs. Organs include the spleen, stomach,
and intestines.
▪Identify abnormalities, such as tumors,
obstructions, abnormal gas or fluid
collections and strictures.
▪The client may be required to lie flat or sit in
the upright position for the x-ray.
▪The test is done in a hospital radiology
department. Or, it may be done in the health
care provider's office by an x-ray
technologist.
▪Men will have a lead shield placed over the
testes to protect against the radiation.
▪You lie on your back on the x-ray table. The x-
ray machine is positioned over your
abdominal area. You hold your breath as the
picture is taken so that the picture will not be
blurry. You may be asked to change position
to the side or to stand up for additional
pictures.
▪No discomfort
▪ You wear a hospital gown during the x-ray
procedure. You must remove all jewelry.
▪ Tell your provider the following:
▪ If you are pregnant or think you could be pregnant
▪ Have an IUD inserted
▪ Have had a barium contrast x-ray in the last 4 days
▪ If you have taken any medicines such as Pepto
Bismol in the last 4 days (this type of medicine can
interfere with the x-ray)
▪The x-ray will show normal structures for a
person your age.
▪ Abdominal masses
▪ Buildup of fluid in the abdomen
▪ Certain types of gallstones
▪ Foreign object in the intestines
▪ Hole in the stomach or intestines
▪ Injury to the abdominal tissue
▪ Intestinal blockage
▪ Kidney stones
▪It helps to identify pathophysiologic
processes in the pancreas, liver, gallbladder,
spleen and retroperitoneal tissues.
▪Used to identify fluid, masses (such as
tumors), adipose tissues, abscesses, and
hematomas.
▪ Physical examination is enhanced by ultrasound
techniques because palpable masses and areas of
tenderness can be correlated with anatomic
structures while the client is on the examining
table.
▪ NPO for 8 – 12 hours – gas may interfere with the
procedure
▪ Reassure client test is painless and safe.
▪ No specific Postprocedure precautions or
observations related to ultrasound.
▪a noninvasive procedure that uses powerful
magnets and radio waves to produce pictures
of the inside of the abdomen without
exposure to ionizing radiation (x-rays).
▪MRI uses radio waves very close in frequency
to those of ordinary FM radio stations, so the
scanner must be located within a specially
shielded room to avoid outside interference.
▪ The patient lies on a narrow table which slides
into a large tunnel-like tube within the scanner.
▪ An IV may be placed in a small vein of the hand or
forearm, if contrast medium will be used.
▪ Operated by a technologist.
▪ Several sets of images are usually required, each
taking from 2-15 minutes.
▪ Duration: 1 hour or more
▪No preparatory tests, diets, or medications are
usually needed, unless the colon needs to be
cleansed (with preparations such as a laxative
or an enema).
▪An MRI can be performed immediately after
other imaging studies. Depending on the area
of interest, the patient may be asked to fast
for 4 to 6 hours prior to the scan.
▪Certain metallic objects are not allowed into
the room. Items such as jewelry, watches, credit
cards, and hearing aids can be damaged.
▪Pins, hairpins, metal zippers, and similar
metallic items can distort the images.
▪Removable dental work should be taken out
just prior to the scan. Pens, pocketknives, and
eyeglasses can become dangerous
projectiles.
▪People with cardiac pacemakers cannot be
scanned and should not enter the MRI area.
▪Contraindicated to people with metallic
objects in their bodies such as inner ear
(cochlear) implants, brain aneurysm clips,
some artificial heart valves, older vascular
stents, and recently placed artificial joints.
▪CT Scanning is used to identify masses, such
as neoplasms, cysts, focal inflammatory lesions,
and abscess of the liver, pancreas, and pelvic
areas.
▪Also aids in evaluating local tumor spread,
especially if barium studies suggest tumor
growth beyond the bowel wall.
▪ To distinguish normal bowel from abnormal
intraperitoneal masses, dilute oral barium or other
contrast media may be administered.
▪ The client is place in supine on the examination table
and asked to lie still and hold breath when instructed.
▪ NPO for 6 – 12 hours before the procedure.
▪ Report any history of allergies to iodine. Non iodine
contrast may be used when allergic to iodine.
▪ No follow up care needed. Painless, primary discomfort
may be from the need to lie still on the table.
▪Gastric emptying scan
▪ to determine how quickly the stomach
empties.
▪Bleeding Scan
▪ determine the location of bleeding in the
digestive tract.
▪Meckel scan
▪ to identify a small intestine problem called a
Meckel diverticulum.
▪ Gastric emptying study, also known as a gastric emptying
scan, or gastric emptying scintigraphy.
▪ A test to determine the time is takes a meal to move
through a person’s stomach. It is typically ordered by
physicians for patients with frequent vomiting,
gastroparesis, abdominal pain, early satiety and pre-
operative evaluation.
▪ NPO after midnight. The client should not eat or drink
anything after midnight the day before the test, and until
after the test is completed.
▪ You will start by eating a light meal, often eggs (scrambled)
and toast together with water. The food will contain a small,
harmless amount of radioactive material called a tracer.
▪ After you finish eating, you will lie down on an x-ray table.
▪ The radiologist will take images of your abdomen, using a
scanning device.
▪ The radiologist will watch the movements of the radioactive
tracer on a monitor. The tracer will show how food travels
through your stomach.
▪ Additional images will be taken over the next few hours to
see how long it takes for food to move out of your stomach
and into your gastrointestinal tract.
▪ You will be allowed to get up and leave the exam room
during this time period.
▪ Your provider will let you know when you need to return for
imaging. It's usually at around 1, 2, and 4 hours after the first
image was taken.
▪ A GI bleeding scan is an imaging test that can help detect the
origin of gastrointestinal bleeding.
▪ During the test, blood (3-5ml) will be drawn from the vein. The
drawn blood will be mixed with a radiopharmaceutical
(radioactivetracer) called Technetium-99m for 30 minutes. The
blood cells will then be reinjected into your client’s vein by the
same technologist who took client’s blood.
▪ A special camera, called a gamma camera, is used to take
pictures of the abdomen once the blood cells have been
reinjected.
▪ Duration: approximately 2 hours.
▪ A GI bleeding scan may be done when client is vomiting
blood or passing blood in her stool. The scan can detect
and localize a small amount of bleeding providing it occurs
during the time of the exam.
▪ There is no patient prep needed for this exam.
▪ A diagnostic imaging procedure that detects the
abnormally-located gastric mucosa.
▪ A radiopharmaceutical called Technetium-99m is injected
into client’s veins. Technetium-99m has a tiny amount of
radioactive molecules in it.
▪ A special camera, called a gamma camera, is used to take
pictures of the abdomen once the radiopharmaceutical has
been injected.
▪ Common to children