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Nursing 272: Final Semester > Unit 3: Chp 55: Diagnostic Studies for Gastrointestinal Assessment > Flashcards

Unit 3: Chp 55: Diagnostic Studies for Gastrointestinal Assessment Flashcards

1
Q

Laboratory Studies

A
  • Complete Blood Count (CBC)
  • Serum chemistry panel
  • Prothrombin Time (PT)
  • Liver Function Tests (LFTs)
  • Urine analysis
  • Stool samples
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2
Q

Laboratory Studies: Complete Blood Count (CBC)

A
  • provides information about potential blood loss through assessment of the red blood cell count (RBC), hemoglobin, and hematocrit
  • white blood cell count (WBC) indicated for evaluation of inflammatory or infectious processes
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3
Q

Laboratory Studies: Serum Chemistry Panel

A
  • obtained to assess for electrolyte imbalances associated w/ impaired absorption or excretion
  • serum albumin, prealbumin, and transferrin levels provide data regarding nutritional status
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4
Q

Laboratory Studies: Prothrombin Time

A
  • w/ suspected liver disease
  • important to assess clotting b/c this test measures the time required for prothrombin to be converted to thrombin and may be prolonged b/c of impaired synthesis of clotting factors in the liver
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5
Q

Laboratory Studies: Liver Function Tests (LFTs)

A

evaluated w/ suspected hepatic (liver) dysfunction

  • ALT
  • AST
  • Albumin
  • Bilirubin
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6
Q

Laboratory Studies: Urine Analysis

A

indicated in patients w/ suspected pancreatitis b/c urine amylase is elevated in this disorder

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7
Q

Laboratory Studies: Stool samples

A

in patients w/ complaints of changes in bowel pattern; collected for occult blood

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8
Q 
Connection Check: The nurse correlates an increase in which laboratory value w/ the diagnosis of pancreatitis?
A. Serum sodium
B. Serum amylase
C. Serum potassium
D. Serum creatinine
A

B. Serum amylase

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9
Q

Patients presenting w/ complaints of abdominal pain typically undergo what diagnostic test?

A

Plain X-ray of the abdomen

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10
Q

Diagnostic Test: Plain x-ray of abdomen

A
  • patients w/ complaints of abdominal pain undergo a routine plain x-ray of the abdomen
  • reveals abnormal masses, obstruction, or strictures
  • requires no preparation; just an explanation
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11
Q

Presence of air in the abdomen

A

consistent with an obstruction and requires further assessment b/c perforation can occur w/ increasing pressure behind the obstruction

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12
Q

Diagnostic Tests

A
  • Plain x-ray of abdomen (routine)
  • Ultrasonography
  • Barium Studies
  • Endoscopy
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13
Q

Ultrasonography

A
  • uses a doppler
  • soundwaves are transmitted to a particular organ
  • sound waves are converted to an electronic image to provide a real-time depiction of the soft tissue structure
  • can detect any size and structural abnormalities of the underlying abdominal cavity organs and vessels
  • preferred method of visualization of abdominal structures in patients who cannot tolerate contrast dye
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14
Q

Ultrasonography: Abdominal Cavity

A

evaluated for presence of ascites

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15
Q

Ultrasonography: of Liver and Pancreas

A

visualized to detect cysts, tumors, or masses

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16
Q

Ultrasonography: Gallbladder and Kidneys

A

further visualized for stones

17
Q

Ultrasonography: As a therapeutic intervention

A

can be utilized to place stents in obstructed areas

18
Q

Barium Studies

A
  • consists of a series of x-rays

- ordered to examine integrity and patency of the GI tract; can be diagnostic or therapeutic

18
Q

Barium Studies

A
  • consists of a series of x-rays
  • ordered to examine integrity and patency of the GI tract; can be diagnostic or therapeutic
  • with the use of fluoroscopy, patients are taken through a series of time-sensitive x-rays
  • several studies that can be performed: upper gastrointestinal series, small bowel series, or barium enema
19
Q

Barium Studies: Upper GI Series

A

visualizes the esophagus, stomach, and duodenum

20
Q

Barium Studies: Small bowel series

A

visualizes small intestine

21
Q

Barium Studies: Barium Enema

A

visualizes the colon

22
Q

Preparation for Barium Studies

A
  • special diet (clear liquids) before the test
  • NPO after midnight (8-12 hours prior to study)
  • laxative or enema may also be prescribed for the night before the study
  • patients typically given barium, a radiographic opaque liquid, to drink
  • if concern for possible perforations anywhere along the GI tract, a water-soluble liquid, gastrografin, is administered
23
Q

Safety Alert: Post-procedure care for Barium Studies

A

increased fluid intake and/or enemas are necessary to prevent constipation and impaction in patients who undergo barium studies

24
Q 
Connection Check: The nurse monitors for which complication in the patient who has undergone a barium enema?
A. Fluid overload
B. Dehydration
C. Diarrhea
D. Constipation
A

D. Constipation

25
Q

Endoscopy

A

general term used to describe the procedure in which a fiberoptic scope is used to visualize the GI tract

  • endoscopic studies serve 3 purposes: diagnostic, curative, or palliative
  • patients are sedated with a narcotic and a sedative
26
Q

After an upper endoscopy

A

nurse monitors for the return of swallow before providing oral intake to decrease risk of aspiration

27
Q

After a lower endoscopy

A

anticoagulation and aspirin are usually held temporarily d/t risk of bleeding

28
Q

Gastric Analysis

A

after a period of fasting, gastric fluid is obtained through a nasogastric (NG) tube or during endoscopic procedure

  • measures gastric acidity
  • assess for presence of: blood, bacteria, medications
29
Q

Teachings for Gastric Analysis

A
  • NPO from 8-12 hours

- refrain from caffeine and alcohol intake at 24 hours prior to test

30
Q

Gastric Analysis: Pre/Intra/Posttest

A

> Pretest:

  • patient education
  • remove loose dentures
  • assess medication intake

> Intratest:
-monitor for patient distress during NG insertion

> Posttest:

  • monitor vital signs
  • patient education on reporting symptoms associated w/ postprocedural complications, further treatment, or lifestyle changes
31
Q

Stool Analysis

A

collected to assess presence of:

  • Blood (gross and occult)
  • Fecal leukocytes
  • Bacteria (C.diff)
  • Parasites
  • Fat
32
Q

Patient Teaching regarding stool analysis

A

education on rationale for test and specimen collection methods

33
Q

Stool Analysis: Pre/Intra/Post

A

> Pretest:

  • analysis and studies should be done prior to the administration of antibiotics, antidiarrheal medications, and laxatives
  • stool specimen should not be collected from toilet
  • patient education on specimen collection

> Posttest:
-patient education on contact isolation if C.diff cultures are positive

34
Q

Liver Function Test: ALT

A

Male: 13-40 units/L
Female: 24-36 units/L

35
Q

Liver Function Test: Albumin

A

3.4 to 5.1 g/dL

36
Q

Liver Function Test: AST

A

Male: 20 to 40 units/L
Female: 15-35 nits/L
(both 20 point difference)

37
Q

Bilirubin

A

> Total Bilirubin: 0.3-1 mg/dL
Indirect Bilirubin: 0.2-0.8 mg/dL
Direct Bilirubin: 0.1-0.3 mg/dL

38
Q

Liver Function Tests: Pre/Intra/Post Test

A
  • collected in a red-top tube
  • previous intramuscular injections may cause increased levels
  • collected in gold-, gray, or red top tube

Nursing 272: Final Semester (79 decks)

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