BE Flashcards by Melissa Ortega

What does a barium enema examination demonstrate? & when is it performed?

The large bowel (colon)

This examination is performed when patients have a change in bowel habits, experience abdominal pain or rectal bleeding, or if diverticulitis or polyps are suspected.

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What is required for successful barium enema examination preparation?

Intestines must be completely empty

Typically involves a restricted diet for two days, taking a laxative the evening before, and fasting after midnight.

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What type of gown should patients wear during a barium enema examination?

A hospital gown without metal snaps

Metal can interfere with the accuracy of the images.

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Who performs the barium enema examination?

A radiographer and a radiologist

The radiographer prepares the patient and takes initial images, while the radiologist interprets the images.

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What is the purpose of liquid barium in a barium enema?

To allow radiographic visualization of the gastrointestinal tract

Barium coats the walls of the lower digestive tract, casting shadows for x-ray recording.

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What sensations might a patient experience during the barium administration?

Pressure and fullness in the bowel

Patients may also have an urge to defecate.

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What is a double-contrast barium enema examination?

An examination that introduces air along with the barium solution

This allows for more detailed images of the colon.

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What should patients do after the barium enema examination?

Expel the barium and increase water consumption

Barium may make stools white for a few days, which is normal.

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True or False: A radiologist specializes in the diagnostic interpretation of medical images.

True

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Fill in the blank: The radiographer will determine the amount of _______ necessary to produce a diagnostically useful image.

[radiation]

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What should a woman of childbearing age disclose before a barium enema examination?

Possibility of pregnancy and date of last menstrual period

This is important because the examination exposes the pelvic area to radiation.

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What happens to the barium after the examination?

It is expelled through the toilet facilities

The radiographer may take another x-ray image to check for remaining barium.

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What sensation may patients feel during the introduction of air in a double-contrast examination?

Cramps or bloating sensation

Patients should try not to expel the air or barium.

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How does barium behave in the colon during the examination?

It clings to the walls rather than filling the colon

The air expands the walls of the colon for better imaging.

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What will your personal physician do after reviewing the radiographs?

Receive a report of the findings and discuss results with you

They will also discuss any further procedures if necessary.

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What is the expected change in stool color after a barium enema?

Stools may appear white for a few days

This is a normal reaction to the barium.

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What should patients do if they experience constipation after the examination?

Tell their doctor

They may be advised to increase water consumption or take a laxative.

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What happens to the radiation exposure during the barium enema examination?

It passes through the patient immediately

Similar to radiation produced during any other x-ray procedure.

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Imaging the colon types

Colonoscopy

Virtual colonoscopy

Sigmoidoscopy

Barium enema

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Colonoscopy

Performed by
Diagnostic or therapeutic
What is it for?
What does it require?

Performed by physician

Diagnostic and therapeutic

95% sensitivity for colon lesions

Requires: preparation

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Virtual colonoscopy

What is it and is it diagnostic or therapeutic?

Five minute CT procedure

Diagnostic only

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Sigmoidoscopy
Performed by
Diagnostic or therapeutic

Performed by physician using a sigmoidoscope

Diagnostic and therapeutic

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Barium enema

Performed by radiology with contrast material in colon

Diagnostic only

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COLON preparation

For?
Wht kind of pts?
Required for what kind of exams?

Used for bowel cleansing and to promote defecation

Outpatient and can be self-administered

Required for contrast, barium enema exam & endoscopy

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Typical preps include

Stool softener – oil base solution Dietary restrictions – low residue diet Purgation – laxatives Hydration plenty- of clear liquids 24 hours before procedure

Why do you need hydration for colon preparation?

Maintain bodies, fluid levels and blood pressure and it can provide a small degree of nutrition

Cleansing enemas Used to When are they administered?

Relieve constipation Administered to patients the morning of exam

What kind of patients present unique variations to prep

Diabetic patients

Giving enemas until clear means that

Fluid is expelled with no fecal matter present

Enema types

Tapwater – hypotonic Hypertonic – fleet enema Saline – safest used on infants Oil retention Soapsuds solution

What is the purpose of a barium enema?

To diagnose pathologic conditions of the colon or lower gastrointestinal tract ## Footnote Barium enema is a diagnostic imaging procedure that uses barium sulfate as a contrast agent.

What type of catheter may be used in a barium enema?

A catheter with a plain tip or an inflatable cuff attached ## Footnote The inflatable cuff is often referred to as a 'balloon.'

What is the function of the inflatable cuff during a barium enema?

To hold the catheter in place and prevent involuntary expulsion of barium ## Footnote The cuff is inflated after the catheter tip is inserted.

What is the capacity of the bags in an empty barium enema kit?

3000 cc's of fluid ## Footnote This capacity is important for holding the barium solution used in the procedure.

What is the atomic number of Barium that provides optimum contrast?

What are the two forms in which Barium can be available as a contrast agent?

Premixed or radiopaque powder

In what type of studies is Barium a popular contrast agent when bowel perforation is NOT suspected?

Enteric studies

What is an important consideration when using Barium as a contrast agent?

Bowel wall coating

What form of Barium is available in a prepared, prepackaged powder?

Suspension mixed with water

How far above the table is the bag of Barium usually suspended?

Up to 30 inches

Is Barium used if bowel perforation or leakage is suspected?

What water-soluble contrast is mentioned as an alternative to Barium?

Gastrografin

What is the chemical name for Gastrografin?

Diatrizoic acid

What is a Double-Contrast Barium Enema used for?

Used for polyps, history of colorectal cancer, and rectal bleeding ## Footnote Excellent for outlining colon mucosa.

What is the appearance of the positive agent in a Double-Contrast Barium Enema?

White ## Footnote Barium is the positive agent.

What is the appearance of the negative agent in a Double-Contrast Barium Enema?

Black ## Footnote Air is the negative agent.

What are the advantages of using a Double-Contrast Barium Enema?

Visualize bowel wall lining, outline colon mucosa ## Footnote Very popular with clinicians.

What patient position is recommended at the start of a Double-Contrast Enema?

Prone position ## Footnote The R/F table is slightly in Trendelenburg position.

What is administered first during a Double-Contrast Enema?

Barium ## Footnote Followed by air.

What happens after the barium is administered in a Double-Contrast Enema?

Patient turned into various oblique positions ## Footnote This helps move barium into colon compartments.

What is the purpose of administering more air during a Double-Contrast Enema?

To contrast with barium adhering to colon mucosa ## Footnote Enhances visualization.

What is the goal of taking radiographic images during a Double-Contrast Enema?

To visualize anatomy ## Footnote Allows assessment of polyps and mucosal irregularities.

Fill in the blank: In a Double-Contrast Barium Enema, barium is a _______ agent.

Positive ## Footnote Positive agents are radioopaque.

Fill in the blank: Air is a _______ agent in a Double-Contrast Barium Enema.

Negative ## Footnote Negative agents are radioluent.

Single contrast barium enema

Larger volume of barium Axis barium is drained back into bag. The tip is removed and the patient is sent to the toilet to evacuate as much of the barium as possible. Post evacuation images taken

Important patient concerns

Keep firmly in rectum Relax, abdominal muscles to reduce intra-abdominal pressure Use deep oral breathing to prevent spasms and cramps -CAN CAUSE CESSATION OF PROCEDURE Take pt attention away from enema

When perforation of the bowel is suspected

Water soluble iodine compounds (Gastrografin) are the only acceptable contrast media

What is a consideration regarding barium in a barium enema procedure?

Barium is naturally hydroscopic and can cause patient dehydration. ## Footnote Hydroscopic substances absorb moisture, which can lead to dehydration if not properly managed.

What color are patient stools typically until barium is fully defecated?

Gray or white. ## Footnote This change in stool color is due to the presence of barium in the digestive system.

Why is it important to stress defecation after a barium enema?

To remove residual barium. ## Footnote Retained barium can lead to complications such as constipation and dehydration.

What dietary changes should a patient make after a barium enema?

Increase fluid intake and dietary fiber. ## Footnote These changes help facilitate the elimination of barium from the body.

What are post-examination instructions to patients considered?

Important. ## Footnote Proper instructions can help prevent complications and ensure patient recovery.

What are colostomy patients referred to medically?

Ostomate patients. ## Footnote This term encompasses individuals who have undergone ostomy surgeries.

What is the most common complication for colostomy patients?

Wound infection. ## Footnote Infection can occur at the stoma site and is a significant concern post-surgery.

How is contrast administered in colostomy patients?

Through a patient stoma. ## Footnote This method allows for imaging studies to be conducted in patients with colostomies.

What should patients have over their stoma?

A dressing. ## Footnote Dressings help protect the stoma and prevent infection.

Colostomy types

Sigmoid Transverse Double barrel

Loopogram

Fluoroscopic study of small bowel and colon throat skin surface connection for the urinary bladder

Why is colonoscopy popular?

95% sensitivity for colon lesions