5 NURSING RESPONSIBILITIES TO DIAGNOSTIC EXAMS

1. NURSING RESPONSIBILITIES FOR
BARIUM SWALLOW
1
 Pre-procedure:
 NPO for 6-8 hours
 Instruct pt about the
procedure
 Tell pt that barium has
a thick consistency
&chalky taste
 16 oz of barium is
swallowed
 Lasts about 45
minutes

2. CONTINUED....
➲ Postprocedure
- Laxative
- Assess abdomen
for bowel distention
- Inform pt that stool
may be white for
up to 72 hours
after
- Call physician if
constipation &
abdominal
distention occurs

3. NURSING RESPONSIBILITIES TO
LOWER GI BARIUM ENEMA
Preprocedure:
 Low residue diet for 1 to 2 days prior to the test
 Clear liquid diet & a laxative the evening before
the test
 NPO after midnight prior to the day of the test
 Cleansing enemas on the morning of the test

4. CONTINUED...
 Postprocedure:
 Instruct the client to drink increased oral
fluid to pass the barium
 Administer a mild laxative as prescribed
 Monitor stool for passage of barium
 Notify the MD if a bowel movement does
not occur within 2 days

5. ANOSCOPY
Anoscopy – use of rigid scope to examine anal
canal
Client is placed in knee-chest position with back
inclined at 45 degrees
Preprocedure: enemas until the returns are clear
Postprocedure: monitor for rectal bleeding & signs of
perforation

6. NURSING RESPONSIBILITIES FOR
ENDOSCOPY
➲ More accurate than radiographic exam
➲ Sedate patient
➲ Left lateral decubitus
(Sims) position

7. CONTINUED....
➲ Preprocedure:
- Signed consent
- Antibiotic prophylaxis if with hx of valve problems
- NPO for 8-12 hours
- Assess oral cavity
- Remove dentures & retainers
- Instruct pt to breathe through the nose during
procedure
- Explain that the room is cool & dark and will not be
able to talk
➲ During procedure:
- Monitor cardiac & respiratory complications
- Assess VS & pulse oximetry frequently

8. CONTINUED...
➲ Post procedure
- NPO until gag reflex
returns
- monitor signs of
perforation
- maintain bedrest for
sedated pts until alert
- Lozenges, saline
gargles or oral
analgesics can relieve
minor sore throat
after gag reflex
returns

9. NURSING RESPONSIBILITIES FOR
COLONOSCOPY
 Preprocedure:
 Adequate cleansing of colon as prescribed
 Clear liquid diet started at noon on the day
before the test
 Consult with the MD regarding medications
that must be withheld prior to the test
 NPO after midnight on the day before the
test
 Midazolam IV is administered to provide
sedation
 Glucagon is administered to relax smooth
muscle

10. CONTINUED...
Postprocedure:
Provide bed rest until alert
Monitor for signs of perforation
Instruct client to report any bleeding

11. NURSING RESPONSIBILITIES FOR
SIGMOIDOSCOPY
Sigmoidoscopy
 Preprocedure: enemas until the returns are
clear
 Postprocedure: monitor for rectal bleeding &
signs of perforation

12. ESOPHAGEAL MANOMETRY
 detects motility disorders of the esophagus
and LES
 NPO for 8 to 12 hours
 Withhold drugs that affect GI motility

13. GASTRIC ANALYSIS
 passage of NGT into the stomach to aspirate
gastric contents for the analysis of acidity
(pH), appearance and volume
 specimen are collected every 15 minutes for 1
hour
 Histamine may be
administered to
stimulate gastric
secretions

14. CONTINUED...
➲ Preprocedure:
NPO for 8-12 hours
Avoid tobacco &
chewing gum for 6
hours prior the test
Withhold drugs
that stimulate
gastric secretions
for 24-48 hours
➲ Postprocedure:
may resume
normal activity
refrigerate samples
if not tested within
4 hours