IMAGING DIAGNOSTIC TESTS (Gastointestinal System)

1.) Upper GIT Study: Fluoroscopy The upper GI (gastrointestinal) series is a test that uses x-rays to diagnose problems in the esophagus, stomach and duodenum (the first part of the small intestine). A thick barium drink is given to the patient to swallow. The barium coats the lining of the esophagus, stomach and duodenum allowing them to show up clearly on the x-ray images. The upper GI series can demonstrate a blockage, abnormal growth, ulcer or identify a problem with organ functioning. The upper GI series is indicated for assessing problems such as abdominal swelling, bloating, pain, nausea, and vomiting. It may be used to detect the cause of painful or difficult swallowing. The radiologist may also find evidence of ulcers, scar tissue, abnormal growths, hiatal hernia (a defect where the upper portion of the stomach slides through the diaphragm), or blockage of the normal food path through the digestive tract. Nursing Responsibilities: Client is to undergo NPO from midnight before the study Nurse advices client against smoking, chewing gum and using mints beacuase they can stimulate gastric motility Oral medications are withheld on the morning of study and resumed at that evening Follow-up care Advice client to increase fluid intake to facilitate evacuation of stool and barium 2.) Lower GIT Study: Barrium Enema A lower GI series, also known as a barium enema, barium enema procedure, barium enema X-ray or double-contrast barium enema, is an X-ray test in which a white liquid, called barium, is infused through a catheter (tube) inserted through the anus and into the rectum until it fills the large bowel (colon). X-ray films of the colon then are taken so that the outline of the colon can be seen. The barium enema and double contrast barium enema are used to define normal and abnormal anatomy of the colon and rectum. Colon and rectal abnormalities that can be detected include diverticulosis, diverticulitis, polyps, colonic abscesses, abnormal colon movement, dilation of the colon, Hirschsprung disease in infants, and cancers. Nursing Responsibilities: Bowel Prep Have patient eat a low-residue diet 1-2 days before the tes; clear liquid diet and a laxative the evening before and NPO after midnight Nurses make sure that barium enemas are scheduled before any Upper GI Series Do not advice patients to take this test who are with inflammatory disease of the colon or perforation or obstruction as well as active GI bleeding.

 Post procedure: health education on increasing fluid intake, evaluate bowel movements, and note increased number of bowel movements (barium has high osmolarity, increasing bulk) 3.) Computerized Tomography CT provides cross-sectional images of athe abdominal organs and structures. Multiply xray images are taken from numerous angles, digitalized in a computer, reconstructed and then viewed on a computer monitor. CT is a valuable too for detecting and localizing many inflammatory conditions in the colon, such as appendicitis, diverticulitis, regional enteritis, etc. Because the adequacy of detail in the test depends on the presence of fat, this test may not be as effective on thin patients. The procedure is completely painless. Nursing Responsibilities: This test may be performed with or without a contrast agent (but better of with contrast agent ) Note any allergies of patient to iodine or seafoods Determine clients present serum creatinine level and urine human chorionic gonadotropine before administering contrast Patients allergic to contrast may be given with IV Prednisone 24 hours, 12 hours, and 1 hour before exam Renal protective measures: IV Sodium Bicarbonate 1 hr before and 6 hrs after contrast and Oral Acetylcysteine before or after the study. 4.) Magnetic Resonance Imaging MRI is used in gastroenterology to supplement ultrasonography and CT. This noninvasive technique uses magnetic fields and radio waves to produce images of are being studied. It is useful in evaluating abdominal tissues as well as blood vessels, abscesses, fistulas, neoplasms, and other sources of bleeding. Before undergoing the test, any metal object is taken from the client such as dentures, paperclips, coins, eyeglasses or any ferromagnetic objects that might interfere with the exam. MRI though is contraindicated to patients with permanent pacemaker, artificial heart valves and defibrillators, implanted insulin pumps, or implanted transcutaneous electrical nerve stimulation devices, internal metal devices intraocular metallic fragments or cochlear implants. Nursing Responsibilities: Patient should be at NPO status for 6-8 hours before the study Remove all jewelry and other metals Inform client and clients family that the study may take 60-90 mins. Know if the patient has phobias for constricted areas Patient may choose to wear headset and listen to music or wear a blindfold 5.) Positron Emission Tomography

A positron emission tomography (PET) scan is a unique type of imaging test that helps doctors see how the organs and tissues inside your body are actually functioning. The test involves injecting a very small dose of a radioactive chemical, called a radiotracer, into the vein of your arm. The tracer travels through the body and is absorbed by the organs and tissues being studied. Next, you will be asked to lie down on a flat examination table that is moved into the center of a PET scannera doughnut-like shaped machine. This machine detects and records the energy given off by the tracer substance and, with the aid of a computer, this energy is converted into three-dimensional pictures. A physician can then look at cross-sectional images of the body organ from any angle in order to detect any functional problems. Uses for PET in brain imaging

Brain tumor imaging Detection of Alzheimer's disease Determination of epileptic focus Assessment of viable areas for experimental tissue transplantation in Parkinson's disease and Huntington's disease Determination of normal from abnormal areas of brain metabolism Determination of normal from abnormal areas of brain perfusion