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Gastro Intestinal Tract Diagnostic Studies Fecal Studies o To detect blood, fat and infectious organisms.

. o Nursing Consideration Collect stool in a clean dry container. Dont Use stool thats been in contact with the toilet bowl water or urine. For fat or infectiousn organisms, collect 3 seperate specimen. Guaic Test o To detect fecal occult blood. o Nursing Consideration Hemoglobin free diet for 3 days Avoid taking medications prior to the test Urea Breath Test o To detect the presence of Helicobacter pylori, the bacteria that can live in the mucosal lining of the stomach and cause peptic ulcer disease. o The patient takes a capsule of carbon labeled urea and then provides a breath sample 10 to 20 minutes later. Rationale: H. pylori metabolizes urea rapidly, the labeled carbon is absorbed quickly; it can then be measured as carbon dioxide in the expired breath to determine whether H. pylori is present. Hematologic Test o To test for hemoglobin, Hematocrit, White Blood Cell, pH Serologic Test o To test for Carcinoembryonic agent(CEA) or Cancer Antigen(CA) Radiography o Abdominal Xray(also called Flat plate of the abdomen) To detect tumor, stones, abnormal gas collections, and other disorders Ultrasonography o Uses a focus beam of increased frequency sound waves to create echoes and form images. HBT- HepatoBillary Tract LGBP-Liver Gallbladder Pancreas WA- Whole Abdomen Upper Gi or Barium Swallow o Fluoroscopic examination of the upper tract to determine structural problem and gastric emptying time o Client must swallow Barium Sulfate or other Contrast Medium, then sequential film are taken as it moves through the system o Nursing Responsibility Pre-Test NPO 6-8 hours Explain that the Barium Enema may taste Chalky Asses for hypersensitivity\ Post-Test Give Laxatives to promote elimination of Barium Lower Gi or Barium Enema o Barium is instilled to the client through an enema and the client must retain the contrast medium until X-ray images are taken to identify structural abnormalities of the colon o Nursing Responsibility Pre-Test NPO pmn Give Laxatives or supository

Explain that cramping maybe felt during the procedure Post-Test Administer Laxatives to promote elimination of Barium. Endoscopy(Esophagogastroduodenoscopy) o Visualization of the esophagus, stomach, duodenum by insertion of a lighted fluoroscope o To observe structures , ulcerations, inflammation, tumor and may include a biopsy o Nursing Responsibility Pre-Test NPO pmn Local anesthetic will be administered Post-Test Explain to patient that the patient can eat when the gag reflex is back. Colonoscopy o Visualization of large intestines and may include a biopsy and removal of foreign substance o Nursing Responsibility Pre-Test NPO pmn Administer Laxatives( 1-3 days) Instrument is inserted in the rectum feeling of pressure might be felt. Post-Test Observe for rectal bleeding and signs of perforation Sigmoidoscopy o Visualization of the sigmoid colon o Nursing Responsibility Pre-Test Light supper & Light breakfast Do bowel preparation Explain to patient that sensation of urge of ndiscofort & abdominal cramping may be experienced Post-Test Asses for perforation. Esophageal Manometry o Measures the esophageal sphincter Normal: 15-25 mmHg Incompetent: 0-5 mmHg GERD Hypertensive: 50 mmHg Achalasia Anorectal Manometry o Measures the internal and external anal sphincter o For patients with unexplained constipation Liver Biopsy o Invasive procedure where a specially designed needle is inserted into the liver to remove a small piece of tissue for study o Nursing Responsibility Pre-test NPO 6-8 hours Hold breathe during biopsy] Position client Left side lying Post-test Asses Vital Signs q8-12 hours; Watchout for pneumothorax Right Side lying position

Oral Disorders Cheilosis (Angular Stomatitis) o Etiology: Mechanical trauma of poorly fitted dentures Over closure of the mouth Riboflavin Deficiency Saliva wets & macerates the infolded skin Poor oral hygeine Emotional tension o Assesment Softening of the skin at the angles of the mouth followed by fissuring and crackling o Treatment Oral hygiene Good nutrition Soft bland diet Antibiotics as perscribed Cheilitis o Etiology Overexposure to sun,radiation o Assesment Scaling, Crusting and painful fissuring of the lower lip o Treatment Protect lips using sun protection Electro or cryosurgery to decrease inflammation Aphtous Ulcer (Canker Sore) o Etiology Viral Stress, fatigue, febrile status, trauma Overexposure to sun o Assesment Small round whte ulcer surronded by a halo of reddened mucosa Painful May be single or mutiple in the inner lip, cheek and tongue o Treatment Soft bland diet Oral hygeiene Topical antibiotics as perscribed Candidiasis Moniliasis o Etiology Bacterial Immunosuppresed o Assesment White cheesy plaque that looks like milk and that can be rubbed off but have an erythematours and bleeding base Pain and fever

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