COLONGIOGRAM/COLON ANGIOGRAPHY

DEFINITION X ray study of the blood vessels in the colon. It uses a radiopaque substances, or dye to make vessels visible under x ray. PURPOSE y y Used to detect abnormalities or blockages in the blood vessels( called occlusions). Used to detect anuerysm, tumor, blood clot, or arteriovenous malformations in the colon

INDICATION y y Aneurysm- an area of a blood vessel that bulges or balloons out Gastrointestinal bleeding

CONTRAINDICATION y y y y y Patients with kidney disease or injury may suffer further kidney damage from the contrast mediums used for angiography. Patients who have blood clotting problems Have known allergy to contrast mediums Those who are allergic to iodine, a component of contrast mediums, may also not be suitable candidates for an angiography procedure Pregnant women are also advised to avoid this procedure

DISADVANTAGES y y y It involves puncturing of an artery, internal bleeding or hemorrhage are possible Infection of the puncture site or bloodstream A stroke or heart attack may be triggered by an angiogram if blood clots or plaque on the inside of the arterial wall are dislodged by the catheter and form a blockage in the blood vessels or artery The colon may also be irritated by the movement of the catheter through its walls during the procedure Patient may develop an allergic reaction to contrast medium used

y y

PATIENT S PREPARATION y Prior to the angiography procedure, patients will be briefed on the details of the test, the benefits and risks, and the possible complications involved, and asked to sign an informed consent form. Patients are advised to stop eating and drinking 8 hours prior to the procedure Jewelries are removed before the procedure and change into the hospital gown A sedative may be administered to relax the patient for the procedure An IV line may be inserted into a vein in the patient s arm before the procedure begins in base medication or blood products are required during the procedure

y y y y

NURSING RESPONSIBILITY y y y We are primarily responsible for the patient s preparation, monitoring and documentation of each procedure. Our role would include screening for any potential contraindication to contrast Starting IV access and monitoring the patient during injection of contrast

avoid getting ultrasound treatments on any part of the body. AND HEPATOBILIARY TREE) DEFINITION is a form of medical ultrasonography (medical application of ultrasound technology) to visualise abdominal anatomical structures. the blood flow inside blood vessels can be evaluated as well (for example. such as deep vein thrombosis or occlusive vascular disease. which could be moved toward the heart or the brain by use of an ultrasound. PURPOSE Used to diagnose abnormalities in various internal organs.y y Vital signs taking and monitoring for signs of hemorrhage Contrast administration and patient assessment are the main nursing responsibilities. PANCREAS. a major problem can occur if someone with a circulatory problem had an unknown blood clot. spleen and abdominal aorta. ABDOMINAL ULTRASOUND (LIVER. If Doppler imaging is added. gallbladder. such as the kidneys. INDICATION Commonly used in the setting of: y y y y y Liver y y In patients with deranged liver function tests Hepatomegaly abdominal pain Suspicion of enlargement of one or more organs Tumors abdominal trauma an obvious or suspected abdominal mass Pancreas y Abnormal pancreatic enzymes(pancreatic amylase and pancreatic lipase) Hepatobiliary tree y Gallbladder or bile duct diseases CONTRAINDICATION Circulatory Problems Anyone with circulatory problems. for example. . It uses transmission and reflection of ultrasound waves to visualise internal organs through the abdominal wall (with the help of gel which helps transmission of the sound waves). Because ultrasounds can speed up circulation and move blood flow to a specific area. liver. to look for renal artery stenosis). pancreas.

NURSING RESPONSIBILITIES y y y For best visualization. People with pacemakers can get ultrasounds in the lower extremities. but they may want to avoid them altogether. causing irregular heartbeats. ADVANTAGES This procedure could be performed: y y y y Quickly Bedside Involves no exposure to x-rays(which makes it useful to pregnant women) Inexpensive compared to other often-used techniques such as computed tomography (CT scan) of the abdomen DISADVANTAGES y y Troublesome imaging if a lot of gas or fats is present inside the bowels Quality of the imaging depends on the experience of the person performing it PATIENT S PREPARATION Preparation for the procedure depends on the nature of the problem and your age. An ultrasound too close to the heart could alter the speed at which the pacemaker functions. This could cause health problems in certain situations. Your health care provider will advise you about specific preparation. Usually patients are asked to not eat or drink for several hours before the examination. schedule abdominal ultrasonography before any examinations that use barium. which can force pus out of the infection and into the surrounding areas. should not receive an ultrasound. This could lead to burns or other injuries from the ultrasound. . This would cause the infection to spread and be perpetuated instead of healed.Infections Anyone who has an acute infection. Pacemakers Anyone who has a cardiac pacemaker should not get an ultrasound in the thoracic area. People with Diminished Sensitivity to Pain Although it is not a common disorder. some people have a diminished sensitivity to pain or do not feel pain at all. Drink five to six full glasses of fluid approximately 1 to 2 hours before the test. Explain that the gel is applied over the area where the transducer is placed. People with diminished sensitivity to pain do not get any ultrasounds because the treatment may be set at an intensity that is too high for them and they would not be able to realize it. whether in the bone or in tissue. especially for people who have heart problems or pacemakers. Irregular heartbeats can be very dangerous. It states that getting an ultrasound when you have an infection would increase blood flow to the infected area.

NURSING REPONSIBILITIES y y Assess vital signs before the examination to provide a baseline and to help to detect changes in the client s condition during and after the procedure Remove any metal items such as the religious medal or clothing that contains metal such as the hooks and eyes on a bra.a gland in the neck that regulates metabolism. pregnant. if possible. abdominal X-ray should be avoided in females until the end of reproduction period and pregnant women to prevent radiation exposure ADVANTAGES y There is no discomfort DISADVANTAGES y y y Pregnant women and children are more sensitive to the risks of the x-ray. Men should have a lead shield placed over the testes to protect against the radiation. Women should tell the health care provider if they are. such as a kidney stone or blockage in the intestine Locate an object that has been swallowed CONTRAINDICATION There are no absolute contraindications. The test is not usually recommended for pregnant women. Metal produces a dense image that may be confused with a tissue abnormality Request a lead apron or collar to shield a fetus or vulnerable body parts during x-rays. or may be. The ovaries and uterus cannot be shielded during the abdominal x-ray because of their location. y THYROID ULTRASOUND DEFINITION A thyroid ultrasound is an imaging method used to see the thyroid -.ABDOMINAL X-RAY DEFINITION a test that can be carried out quickly and easily in an emergency department. but. . quickly and effectively. PATIENT S PREPARATION No preparation is needed for the investigation. INDICATION y y y Diagnose a pain in the abdomen or unexplained nausea Identify suspected problems in the urinary system. PURPOSE The test can rule out major illnesses such as a small or large bowel obstruction.

PURPOSE It is usually done when you have a growth on your thyroid gland. numbness To guide invasive procedures -. and sometimes it is crucial information NURSING RESPONSIBILITIES y y For best visualization. You may need to take off you clothes and jewelry. or physician sonologist conducting the examination about any pain. irritability. tremors. depression. muscle weakness. heat intolerance. . hair thinning.muscle spasm. weight gain. sweating. Hyperparathyroidism -. INDICATION Pain in the anterior neck Swelling in the anterior neck Symptoms of abnormal thyroid hormone: 1.. sonologist. weight loss. telling the examiner about past ultrasounds and surgeries is helpful.fatigue.e. Hypothyroidism -. sampling or withdrawal of fluid (abscess. Hypoparathyroidism -. weight loss. bleeding. lack of energy 2. The exam can help tell the difference between a sac containing fluid (cyst) and abnormal tissue that may or may not be cancerous (a tumor). palpitation Symptoms of abnormal parathyroid hormone: 1. weakness. and put on a hospital gown. schedule abdominal ultrasonography before any examinations that use barium. thyroid cancer). cold intolerance. cyst) ADVANTAGES This procedure could be performed: y y y y Quickly Bedside Involves no exposure to x-rays(which makes it useful to pregnant women) Inexpensive compared to other often-used techniques such as computed tomography (CT scan) of the abdomen DISADVANTAGES y y Troublesome imaging if a lot of gas or fats is present inside the bowels Quality of the imaging depends on the experience of the person performing it PATIENT S PREPARATION No special preparation is needed. inability to sleep. Hyperthyroidism -. Tell the sonographer.needle biopsy (i.kidney stone. Also.nervousness. muscle cramps 2. or any other symptoms you might have. loose-fitting clothing. Explain that the gel is applied over the area where the transducer is placed. You should wear comfortable.

. CONTRAINDICATION y y y y y presence of aneurysm extensive esophageal varicosities acute necrotic or corrosive esophagitis Water starvation Un co-operative patient. An esophagoscope is a thin. The stomach needs to be empty. such as removal of swallowed objects and polyps and stretching of narrowed areas of esophagus INDICATION y y y y dysphagia (difficulty in swallowing) hoarseness breathing difficulties used to obtain a biopsy (tissue sample) of a benign or malignant growth.E. ADVANTAGES y y y extremely worthwhile and safe procedure Painless Done under a light sedative as a day-case patient in a specialised endoscopy unit DISADVANTAGES y y y y y perforation in which a small tear through the wall may allow leakage of digestive fluid aspirating the fluid until the opening seals or may require surgery. tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Bleeding may occur from the site of biopsy or polyp removal Localized irritation of the vein may occur at the site of medication injection tender lump develops PATIENT S PREPARATION y y y You should not eat for 4-6 hours before the test. PURPOSE y y y helpful for the diagnosis of inflammation of the esophagus detect early cancers too small needed for treatment. (Small sips of water may be allowed up to two hours before the test. Advice about medication which may need to be stopped before the test.VISUALIZATION ESOPHAGOSCOPY DEFINITION Examination of the esophagus using an esophagoscope.) If you have a sedative you will need somebody to accompany you home.

or tumours. Vomiting blood. INDICATION y y y y y y recurring indigestion recurring heartburn pains in the upper abdomen repeated vomiting difficulty swallowing other symptoms thought to be coming from the upper gut. PURPOSE The doctor can study the mucous membrane of the stomach from the top to the bottom. and whether there are any ulcers in the stomach or duodenum. and see irritation. Uncontrolled hypertension . Black. advise them to stop taking insulin until after the procedure. regardless of etiology Massive upper GI bleeding with hypotension where emergency surgery is clearly appropriate. It is performed by using a thin. tarry stool. operate machinery or return to work on the day of the examination Tell the patient to report the doctor if these symptoms occur: Severe pain. flexible fibre-optic instrument that is passed through the mouth and allows the doctor to see whether there is any damage to the lining of the oesophagus (gullet) or stomach. Difficulty swallowing. IV insertion Ask the patient to sign an informed consent Monitor the vital signs of the patient DURING THE PROCEDURE y Assist the patient in the proper position (left side) AFTER THE PROCEDURE y y y y Advise the patient to have nothing to eat or drink 1-2 hours and until gag reflex returns Inform the patient that he/she may have temporary sore throat Tell the patient to do not attempt to drive. stomach and duodenum. CONTRAINDICATION y y y y y Acute myocardial infarction Hypoxemia with respiratory distress Hypotension and shock. Difficulty breathing GASTROSCOPY DEFINITION an examination of the inside of the gullet.NURSING RESPONSIBILITY BEFORE THE PROCEDURE y y y y y Ensure that the client s stomach must be empty of advise the client to have nothing to eat or drink starting at the midnight prior to procedure In diabetic patients. wounds.

PURPOSE It is used to localise. operate machinery or return to work on the day of the examination Tell the patient to report the doctor if these symptoms occur: Severe pain.y Un cooperative patient ADVANTAGES y y Painless Done under a light sedative as a day-case patient in a specialised endoscopy unit DISADVANTAGES y y y y mild sore throat for a day or so afterwards feel tired or sleepy for several hours if patient have a sedative slightly increased risk of developing a chest infection or pneumonia causes some damage to the gut(bleeding. advise them to stop taking insulin until after the procedure. Advice about medication which may need to be stopped before the test. tarry stool.) If you have a sedative you will need somebody to accompany you home. perforation) PATIENT S PREPARATION y y y You should not eat for 4-6 hours before the test. The stomach needs to be empty. Difficulty breathing DUODENOSCOPY DEFINITION Examination of the luminal surface of the duodenum with an endoscope. Difficulty swallowing. Black. to obtain biopsy material and perform other surgical interventions. infection. and photograph pathologic alterations. IV insertion Ask the patient to sign an informed consent Monitor the vital signs of the patient DURING THE PROCEDURE y Assist the patient in the proper position (left side) AFTER THE PROCEDURE y y y y Advise the patient to have nothing to eat or drink 1-2 hours and until gag reflex returns Inform the patient that he/she may have temporary sore throat Tell the patient to do not attempt to drive. and for delivery of medication . Vomiting blood. NURSING RESPONSIBILITIES BEFORE THE PROCEDURE y y y y y Ensure that the client s stomach must be empty of advise the client to have nothing to eat or drink starting at the midnight prior to procedure In diabetic patients. and rarely. (Small sips of water may be allowed up to two hours before the test. identify.

(Small sips of water may be allowed up to two hours before the test. Difficulty swallowing. advise them to stop taking insulin until after the procedure. Bleeding may occur from the site of biopsy or polyp removal Localized irritation of the vein may occur at the site of medication injection tender lump develops PATIENT S PREPARATION y y y You should not eat for 4-6 hours before the test. Black. IV insertion Ask the patient to sign an informed consent Monitor the vital signs of the patient DURING THE PROCEDURE y Assist the patient in the proper position (left side) AFTER THE PROCEDURE y y y y Advise the patient to have nothing to eat or drink 1-2 hours and until gag reflex returns Inform the patient that he/she may have temporary sore throat Tell the patient to do not attempt to drive. Advice about medication which may need to be stopped before the test. operate machinery or return to work on the day of the examination Tell the patient to report the doctor if these symptoms occur: Severe pain.INDICATION y y y y recurring indigestion pain in the abdomen repeated vomiting other symptoms thought to be coming from the upper gut. The stomach needs to be empty. tarry stool.) If you have a sedative you will need somebody to accompany you home. Vomiting blood. NURSING RESPONSIBILITIES BEFORE THE PROCEDURE y y y y y Ensure that the client s stomach must be empty of advise the client to have nothing to eat or drink starting at the midnight prior to procedure In diabetic patients. Difficulty breathing . CONTRAINDICATION y must be modified in pregnant women ADVANTAGES y y Painless Done under a light sedative as a day-case patient in a specialised endoscopy unit DISADVANTAGES y y y y y perforation in which a small tear through the wall may allow leakage of digestive fluid aspirating the fluid until the opening seals or may require surgery.

under visual control. such as Gatorade & gelatin y y y y .COLONOSCOPY DEFINITION a procedure that enables an examiner (usually a gastroenterologist) to evaluate the inside of the colon (large intestine or large bowel). Patients should not drink beverages containing red or purple dye. The colonoscope is a four foot long. PURPOSE done to investigate the cause of blood in the stool. diarrhea. and bloating in the abdomen Bleeding may occur at the site of biopsy or removal of polyps perforation or a tear through the colonic wall PATIENT S PREPARATION y the patient s colon must be clean or they are required to drink a large volume of a special cleansing solution or several days of a clear liquid diet and laxatives or enemas prior to the examination to inform the physician of what medication is taking to inform the physician of allergies and any other major illnesses A laxative or an enema may be required the night before colonoscopy all solids must be emptied from the gastrointestinal tract by following a clear liquid diet for 1 to 3 days before the procedure. cramping. or an abnormality found on colonic X-rays or a computerized tomographic (CT) scan. INDICATION y y y y y previous history of polyps or colon cancer certain individuals with a family history of some types of non-colonic cancers or colonic problems that may be associated with colon cancer (such as ulcerative colitis and colonic polyps) abdominal pain diarrhea a change in bowel habit CONTRAINDICATION y must be modified in pregnant women ADVANTAGES It is the best method available to detect. into the rectum and through the colon usually as far as the cecum. strained fruit juice. which is the first part of the colon. Acceptable liquids include: fat-free bouillon or broth. diagnose. and treat abnormalities within the colon DISADVANTAGES y y y slight discomfort maybe felt such as a feeling of pressure. plain coffee. abdominal pain. The tip of the colonoscope is inserted into the anus and then is advanced slowly. flexible tube about the thickness of a finger with a camera and a source of light at its tip. sports drinks. a change in bowel habit. water. plain tea.

and iron preparations are examples of medications that may require special instruction and be informed to the physician. foods with seeds. blood thinners (warfarin [Coumadin]. rectal bleeding of more than half a cup. or fever and chills . IV insertion Ask the patient to sign an informed consent Monitor the vital signs of the patient Aspirin products.NURSING RESPONSIBILITIES BEFORE THE PROCEDURE y y y y y y Ensure that the client s stomach must be empty of advise the client to have nothing to eat or drink starting at the midnight prior to procedure In diabetic patients. advise them to stop taking insulin until after the procedure.arthritis medications. insulin. etc. Instruct the client to inform the physician of allergies and any other major illnesses Instruct the client to avoid certain foods for a couple of days prior to the procedure. such as stringy foods. or red Jello. y y DURING THE PROCEDURE y Assist the patient in the proper position (left side or back) AFTER THE PROCEDURE y y y The patient should be able to eat upon returning home Tell the patient to do not attempt to drive. operate machinery or return to work on the day of the examination Tell the patient to report the doctor if these symptoms occur: severe abdominal pain.).

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