GASTROINTESTINAL 

DIAGNOSTIC TESTS-

X-RAY USES

TO ID LOCATION & STRUCTURE OF ORGANS & MASSES IE AIR, FLUID, TUMORS, FOREIGN OBJECTS, STRICTURES, BOWEL GAS PATTERNS, DIFFERENTIATE ILEUS FROM OBSTRUCTION

   INSERT/VERIFY POSITION OF SMALL BORE FEEDING TUBES 

  ID SWALLOWING ABNORMALITIES IE INCOORDINATION OF SWALLOWING, ASPIRATION, & STRUCTURAL ABNORMALITIES OF UPPER GI TRACT

TUMORS, VARICES, HIATAL HERNIA

OBSERVE STOMACH & FIRST PART OF SMALL INTESTINE

GASTRIC TUMORS, PEPTIC ULCERS

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

BARIUM SWALLOW/UPPER GI SERIES

NURSING CONSIDERATIONS

•  NPO BEFORE, PUSH PO FLUIDS AFTER

•  TEACH PT. STOOLS WILL BE WHITE

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

SMALL BOWEL SERIES (SMALL BOWEL FOLLOW THROUGH) USES

LIKE UPPER GI BUT FOCUS ON SMALL BOWEL & USES MORE BARIUM

ID TUMORS, INFLAMMATION, OR OBSTRUCTION OF JEJUNUM OR ILEUM

  MAY USE GASTROGRAFEN INSTEAD OF BARIUM

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

ENTEROCLYSIS (SMALL BOWEL ENEMA)

–     BARIUM INJECTED BY NG TUBE INSERTED INTO JEJUNUM

–     MAY TAKE 6 HR. SO MAY NEED SEDATION SO WATCH AIRWAY

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

BARIUM ENEMA (LOWER GI SERIES)

USES

ID POLYPS, TUMORS, STRICTURES OF RECTUM, SIGMOID COLON, DESCENDING COLON

X-RAY DONE WITH BARIUM IN & AFTER BARIUM EXPELLED

 MAY INJECT AIR TO COMPRESS BARIUM AGAINST MUCOSA TO OBSERVE MUCOSAL DEFECTS

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

BARIUM ENEMA (LOWER GI SERIES)

NURSING 

BEFORE: NPO EXCEPT H2O & MEDS BEFORE, CLEAR LIQUIDS OR LOW RESIDUE DIET FOR SEVERAL DAYS BEFORE. LAXATIVE (GO-LYTLEY) PREP NIGHT BEFORE. ENEMAS X3 OR TILL CLEAR

AFTER: PUSH PO FLUIDS, MONITOR FOR BOWEL OBSTRUCTION & TELL PT. STOOL WILL BE WHITE  PT.MAY NEED LAXATIVE TO HELP EXCRETE BARIUM

GASTROINTESTINAL --

DIAGNOSTIC TESTS-

ORAL CHOLECYSTOGRAM (GALLBLADDER SERIES)

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

ORAL CHOLECYSTOGRAM (GALLBLADDER SERIES)

NURSING

OBTAIN INFORMED CONSENT

ASSESS FOR IODINE ALLERGY

COMPLETE BOWEL PREP IF ORDERED

NPO

TELL PT. THAT DYE INJECTION CAUSE A WARM, FUNNY FEELING & NAUSEA

PUSH PO FLUIDS AFTER TO EXCRETE DYE 

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

RADIONUCLIDE SCANS

–  TECHNETIUM ION ORALLY OR IV

–  ORGAN SCANNED – TELLS SIZE, DEFECTS, & LESIONS, GI BLEEDING & EMPTYING

GASTROINTESTINAL -- DIAGNOSTIC TESTS- RADIONUCLIDE SCANS

NURSING

ASSESS FOR ALLERGY TO RADIOACTIVE NUCLIDES

WEIGH PT. (DOSE WT. BASED)

ASK FEMALE PT. IF ANY POSSIBILITY OF P.G.

TEACH BREAST FEEDING PT. TO PUMP & DISCARD BREAST MILK

WEAR GLOVES & WASH HANDS AFTER HANDLING URINE & FECES

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

MRI & CT

USES

GASTROINTESTINAL --

DIAGNOSTIC TESTS- CT NURSING

BOWEL PREP, GIVE ORAL CONTRAST & MEDS TO ALTER GI MOTILITY IF ORDERED

–   NPO

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

MRI  NURSING

USUAL PT. TEACHING & FACILITY CHECKLIST

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

ULTRASOUND 

•     USED FOR LIVER, PANCREAS, & BILIARY TRACT

•     SHOWS SIZE & LOCATION, OUTLINE OF STRUCTURES & LESIONS, CHOLECYSTITIS, CHOLELITHIASIS, PYLORIC STENOSIS 

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

LIVER BIOPSY

OBTAINS SAMPLE OF LIVER CELLS TO EXAMINE FOR INFECTION, CANCER, STRUCTURAL CHANGES IE CIRRHOSIS

   DONE IN PT. ROOM OR IN X-RAY: MAY BE GUIDED BY MRI OR CT

GASTROINTESTINAL -- DIAGNOSTIC TESTS- LIVER BIOPSY

NURSING:  OBTAIN 

BIOPSY TRAY & INFORMED CONSENT

BASELINE VITAL SIGNS

GASTROINTESTINAL -- DIAGNOSTIC TESTS- LIVER BIOPSY

NURSING

PUT PT. SUPINE WITH ROLLED TOWEL BENEATH RIGHT LOWER RIBS & R. HAND BEHIND HEAD

GIVE SEDATION IF ORDERED & MONITOR PT.

INSTRUCT PT. TO TAKE DEEP BREATH & HOLD IT WHEN NEEDLE INSERTED

POST BX. APPLY PRESSURE DRSG TO SITE & TURN PT. ONTO R. SIDE

MONITOR VS, BREATH SOUNDS, ABD. & BLEEDING PER POLICY – REPORT CHANGES TO MD

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

ENDOSCOPY – VARIOUS TYPES

EGD (ESOPHAGOGASTRODUODENO-SCOPY) 

ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)

ENDOSCOPIC ULTRASOUND (EUS)

GASTROINTESTINAL -- DIAGNOSTIC TESTS- ENDOSCOPY – VARIOUS TYPES

MOST COMMON DONE AT BEDSIDE

USED TO VISUALLY INSPECT THE GI MUCOSA & LESIONS, OBTAIN BIOPSIES & SAMPLES, INJECT DYES, TREAT CERTAIN LESIONS & CONDITIONS

GASTROINTESTINAL -- DIAGNOSTIC TESTS- ENDOSCOPY – VARIOUS TYPES

EGD (ESOPHAGOGASTRODUODENO-SCOPY) NURSING

BEFORE

• NPO

• BOWEL PREP FOR COLONOSCOPY

• OBTAIN INFORMED CONSENT

• OBTAIN BASELINE VITAL SIGNS

• GIVE SEDATION AS ORDERED

GASTROINTESTINAL -- DIAGNOSTIC TESTS- ENDOSCOPY – VARIOUS TYPES

EGD (ESOPHAGOGASTRODUODENO-SCOPY) NURSING

CONSCIOUS SEDATION MONITORING

MONITOR FOR COMPLICATIONS: FEVER, CHEST PAIN (RUPTURED ESOPHAGUS), GI DISTRESS, BLEEDING, SHOCK R/T ORGAN DAMAGE 

NPO & SIDELYING POSITION UNTIL GAG REFLEX RETURNS 

WHEN ABLE TO TAKE PO START WITH CHIPS & SIPS  (ICE CHIPS & H2O) IN SMALL AMOUNTS (» 30CC/H)

GASTROINTESTINAL -- DIAGNOSTIC TESTS- ENDOSCOPY  ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)

INSERT ENDOSCOPE ORALLY INTO COMMON BILE, HEPATIC, & PANCREATIC DUCTS

DYE INJECTED & X-RAYS TAKEN

SHOWS LOCATION OF OBSTRUCTIONS

STONES MAY BE ABLE TO BE REMOVED

NURSING SAME AS EGD

GASTROINTESTINAL -- DIAGNOSTIC TESTS- ENDOSCOPY  ENDOSCOPIC ULTRASOUND (EUS)

USED FOR TUMORS OF PANCREAS, STOMACH & RECTUM

ULTRASOUND IS DONE THROUGH THE ENDOSCOPE

GASTROINTESTINAL -- DIAGNOSTIC TESTS- PY TEST (BREATH TEST)USED TO DETECT 

HELICOBACTER PYLORI REACTIVATION IN PT. WHO CAN’T TOLERATE EGD

GASTROINTESTINAL -- DIAGNOSTIC TESTS- PY TEST (BREATH TEST)

how test is preformed

PT. SWALLOWS C-UREA CAPSULE & WAITS 10 MIN.

PT. BLOWS UP A BALLOON

BALLOON AIR IS ANALYZED FOR GASTRIC URASE (GIVEN OFF BY H PYLORI) 

GASTROINTESTINAL -- DIAGNOSTIC TESTS- PY TEST (BREATH TEST)

NURSING BEFORE

NO ANTIBIOTICS & BISMUTH (PEPTO BISTHMOL) X 1 MONTH

NO PROTON PUMP INHIBITORS OR SUCRALAFATE X 2 WEEKS

NPO X 6 HRS. 

TELL PT. NOT TO HANDLE OR CHEW C-UREA CAPSULE

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

STOOL ANALYSIS

H. PYLORI ANTIGEN (NEW) 

C&S

OVA & PARASITES

FAT

GUIAC

GASTROINTESTINAL -- DIAGNOSTIC TESTS-

STOOL ANALYSIS 3 days before

GASTROINTESTINAL -- DIAGNOSTIC TESTS- STOOL ANALYSIS NURSING

COLLECT SPECIMEN & TAKE TO LAB PROMPTLY 

GASTROINTESTINAL -- DIAGNOSTIC TESTS- BLOOD TESTS

HEPATIC ENZYMES 

AST (ASPARTATE AMINOTRANSFERASE)

ALT (ALANINE AMINOTRANSFERASE)

LDH (LACTATE DEHYDROGENASE)

GASTROINTESTINAL -- DIAGNOSTIC TESTS- BLOOD TESTS

LIVER

TOTAL, DIRECT, INDIRECT

GASTROINTESTINAL -- DIAGNOSTIC TESTS- BLOOD TESTS

GASTROINTESTINAL -- DIAGNOSTIC TESTS- BLOOD TESTS

GASTROINTESTINAL -- DIAGNOSTIC TESTS- BLOOD TESTS

GASTROINTESTINAL -- DIAGNOSTIC TESTS- BLOOD TESTS

GASTROINTESTINAL -- DIAGNOSTIC TESTS- BLOOD TESTS

GASTROINTESTINAL -- DIAGNOSTIC TESTS- BLOOD TESTS other 

AMYLASE – PANCREATITIS

UROBILINOGEN – LIVER

BILIRUBIN -- LIVER