This document outlines procedures and tests related to the gastrointestinal system. It provides instructions for clients undergoing GI procedures like upper GI studies, colonoscopies, liver biopsies, and more. Preparation often involves clear liquid or low-residue diets, laxatives, and staying NPO before the procedure. Post-procedure care includes monitoring for complications, slowly advancing diet, and following pain management.

3.  Examination of the upper GI tract under
fluoroscopy after the client drinks barium
sulfate

4.  NPO after midnight the day of the test
 A laxative may be prescribed
 Instruct client to increase oral fluid intake
to help pass the barium
 Monitor stools for the passage of barium
(chalky white stools) because barium
can cause a bowel obstruction

5.  A fluoroscopic and radiographic
examination of the large intestine is
performed after rectal instillation of
barium sulfate

6.  A low-residue diet is given for 1 to 2 days
before the test
 A clear liquid diet and laxative are given
the evening before the test
 NPO after midnight the day of the test
 Cleansing enemas on the morning of the
test

7.  Instruct client to increase oral fluid intake
to help pass the barium
 Administer a mild laxative as prescribed
to facilitate emptying of the barium
 Monitor stools for the passage of barium
 Notify the physician if a bowel
movement does not occur within 2 days

8.  Requires the passage of a nasogastric
tube into the stomach to aspirate gastric
contents for the analysis of acidity,
appearance, and volume; the entire
gastric contents are aspirated, and then
specimens are collected every 15
minutes for 1 hour

9.  Fasting for 8 to 12 hours is required before
the test
 Tobacco and chewing gum are avoided 6
hours before the test
 Client may resume normal activities after
 Refrigerate gastric samples if not tested
within 4 hours

10.  Also known as
esophagogastroduodenoscopy
 Following sedation, an endoscope is
passed down the esophagus to view the
gastric wall, sphincters, and duodenum;
tissue specimens can be obtained

11.  The client must be NPO for 6 to 12 hours
before the test
 A local anesthetic (spray or gargle) is
administered along with medication that
provides conscious sedation and relieves
anxiety, such as IV midazolam (Versed),
just before the scope is inserted

12.  Atropine sulfate may be administered to
reduce secretions
 Client is positioned on the left side to
facilitate saliva drainage and to provide
easy access of the endoscope
 Airway patency is monitored during the
test and pulse oximetry is used to monitor
oxygen saturation

13.  Client must be NPO after the procedure
until gag reflex returns
 Monitor for pain, bleeding, unusual
difficulty swallowing, elevated
temperature
 Maintain bed rest for the sedated client
until alert

14.  Requires the use of a rigid scope to
examine the anal canal
 Client is placed in the knee-chest or left
lateral position

15.  Require the use of a flexible scope to
examine the rectum and sigmoid colon
 The client is placed on the left side with
the right leg bent and placed anteriorly

16.  Enemas are given before the procedure
until the returns are clear
 Monitor for rectal bleeding and signs of
perforation and peritonitis

17.  The lining of the large intestine is visually
examined; biopsies can be performed
 Performed with the client lying on the left
side with the knees drawn up to the
chest; position may be changed during
the test to facilitate passing of the scope

18.  A clear liquid diet is started on the day
before the test
 Consult the physician regarding
medications that must be withheld
before the test
 Client is NPO after midnight on the day
of the test

19.  Midazolam (Versed) is administered
intravenously to provide sedation
 Provide bed rest until alert
 Monitor for signs of bowel perforation
and peritonitis
 Instruct the client to report any bleeding

20.  Examination of the hepatobiliary system
is performed via a flexible endoscope
inserted into the esophagus to the
descending duodenum
 Multiple positions are required during the
procedure to pass the endoscope

21.  Client is NPO for several hours before the
procedure
 Sedation is administered before the
procedure
 Monitor vital signs
 Monitor for the return of the gag reflex

22.  Transabdominal removal of fluid from the
peritoneal cavity for analysis

23.  Have client void before the start of the
procedure to empty the bladder and to
move the bladder out of the way of the
paracentesis needle
 Measure abdominal girth, weight, and
baseline vital signs
 Fowler’s position is used for the client
confined to bed

24.  Monitor vital signs
 Measure fluid collected, describe and
record
 Label fluid samples and send to the
laboratory for analysis
 Apply a dry sterile dressing to the
insertion site; monitor site for bleeding

25.  Measure abdominal girth and weight
 Monitor for hematuria
 Instruct the client to notify the physician if
the urine becomes bloody, pink, or red

26.  A needle is inserted through the
abdominal wall to the liver to obtain a
tissue sample for biopsy and microscopic
examination

27.  Assess results of coagulation tests
 Administer a sedative as prescribed
 Position client supine or left lateral to
expose the right side of the abdomen
 Assess vital signs

28.  Asses biopsy site for bleeding
 Monitor for peritonitis
 Maintain bed rest for several hours
 Place the client on the right side with a
pillow after the procedure
 Instruct the client to avoid coughing and
straining as well as heavy lifting for 1
week

29.  Detects the presence of Helicobacter
pylori, the bacteria that cause peptic
ulcer disease
 The client consumes a capsule of
carbon-labeled urea and provides a
breath sample10 to 20 minutes later

31.  Is the backflow of gastric and duodenal
contents into the esophagus
 The reflux is caused by an incompetent
lower esophageal sphincter, pyloric
stenosis, or motility disorder

32.  Pyrosis
 Dyspepsia
 Regurgitation
 Pain and difficulty with swallowing
 Hypersalivation

33.  Instruct the client to avoid factors that
decrease lower esophageal sphincter
pressure or cause esophageal irritation
 Instruct the client to eat a low-fat, high fiber
diet
 Instruct client to avoid anticholinergics
 Instruct client to avoid caffeine, tobacco,
and carbonated beverages

34.  Instruct client to avoid eating and
drinking 2 hours before bed time, and
wearing tight clothes
 Elevate the head of the bed on a 6 to 8
inch blocks
 Instruct the client regarding prescribed
medications, such as antacids, H2-
receptor antagonists, or proton pump
inhibitors

36.  Inflammation of the stomach or gastric
mucosa
 Caused by ingestion of food
contaminated with disease causing
microorganisms or food that is too
irritating, or too highly seasoned, the
overuse of aspirin and NSAIDS, excessive
alcohol intake, smoking, or reflux

37.  Abdominal discomfort
 Anorexia, nausea,
and vomiting
acute
 Headaches
 Hiccuping

38.  Anorexia, nausea,
and vomiting
 Belching
 Heartburn after eating chronic
 Sour taste in the mouth
 Vitamin B12 deficiency

39.  Food and fluids may be withheld until
symptoms subside; afterward, ice chips
can be given followed by clear fluids,
and then solid food
 Monitor for signs of hemorrhagic gastritis
such as hematemesis, tachycardia and
hypotension

40.  Instruct client to avoid irritating foods,
fluids and other substances, such as
spicy and highly seasoned foods,
caffeine, alcohol, and nicotine

42.  Is an ulceration in the mucosal wall of
the stomach, pylorus duodenum, or
esophagus in portions accessible to
gastric secretions
 May be referred to as gastric, duodenal,
esophageal, depending on its location
 The most common are gastric and
duodenal ulcers

43.  Antral region and  Pyloric region
lesser curvature
 Peak age 50-60  Peak age 30-45
years old years old
 Normal to  Increased acid
decreased acid secretion
secretion
 Melena
 Hematemesis

44.  H. pylori (60-80%)  H. pylori (100%)
 Food-pain pattern  Pain-food-relief
pattern
 Weight loss is  No weight loss
common
 Gnawing sharp pain  Burning pain occurs
in or left of the in the midepigastric
midepigastric region area 1 ½ to 3 hours
30 – 6o minutes after after a meal and
meal during the night

45.  Monitor vital signs and for signs of bleeding
 Administer small, frequent bland feedings
during the active phase
 Administer H2 antagonist as prescribed to
decrease the secretion of gastric acid
 Administer antacids as prescribed to
neutralize gastric seretions

46.  Administer anticholinergics as prescribed
to reduce gastric motility
 Administer mucosal barrier protectants
as prescribed 1 hour before each meal
 Inform client to avoid consuming alcohol
and substances that contain caffeine or
chocolate
 Avoid aspirin or NSAIDs

47.  Avoid smoking
 Obtain adequate rest and reduce stress

48.  Total Gastrectomy – removal of the
stomach with attachment of the
esophagus to the jejunum or duodenum
 Billroth 1 – partial gastrectomy, with the
remaining segment anastomosed to the
duodenum

49.  Billroth 2 – Partial gastrectomy with the
remaining segment anastomosed to the
jejunum
 Pyloroplasty – enlargement of the
pylorus to prevent or decrease pyloric
obstruction, thereby enhancing gastric
emptying

50.  Monitor vital signs
 Place in a Fowler’s position for comfort
and to promote drainage
 Monitor intake and output
 Administer fluids and electrolytes as
prescribed

51.  Assess bowel sounds
 Monitor nasogastric suction as
prescribed
 Do not irrigate or remove the nasogastric
tube; assist physivian in irrigation and
removal
 Maintain NPO status as prescribed for 1
to 3 days until peristalsis occurs

52.  Progress the diet from NPO to sips of
clear water to six small bland meals a
day, as prescribed when bowel sounds
return
 Monitor for postoperative complications
of hemorrhage, dumping syndrome,
diarrhea, hypoglycemia, and vitamin
B12 deficiency

53.  The rapid emptying of the gastric
contents into the small intestine that
occurs following gastric resection
 Symptoms occurring 30 minutes after
eating
 Nausea and vomiting

54.  Feelings of abdominal fullness and
abdominal cramping
 Diarrhea
 Palpitations and tachycardia
 Perspiration
 Weakness and dizziness
 Borborygmi

55.  Eat a high-protein, low carbohydrate
diet
 Eat small meals and avoid consuming
fluids with meals
 Lie down after meals
 Take antispasmodic as prescribed to
delay gastric emptying

57.  An inflammatory disease that can occur
at anywhere in the GI tract but most
often affects the terminal ileum and
leads to thickening and scarring, a
narrowed lumen, ulcerations, and
abscesses
 Characterized by remissions and
exacerbations

58.  Fever
 Cramp-like and colicky pain after meals
 Diarrhea, which may contain pus and
mucus
 Abdominal distention
 Anorexia, nausea, and vomiting

59.  Weight loss
 Anemia
 Dehydration
 Electrolyte imbalances

60.  Restrict client's activity to reduce
intestinal activity
 Monitor bowel sounds and for
abdominal tenderness and cramping
 Monitor stools, noting color, consistency
and the presence of blood

61.  Instruct client to avoid gas-forming
foods, milk products, nuts, raw fruits and
vegetables, pepper, alcohol, and
caffeine containing products
 Instruct the client to avoid smoking

63.  Inflammation of the gallbladder that
may occur as an acute or chronic
process
 Acute inflammation is associated with
cholelithiasis
 Chronic cholecytitis results when
inefficient bile emptying and gallbladder
muscle wall disease cause fibrotic and
contracted gallbladder

64.  Acalculous cholecystitis occurs in the
absence of gallstones and is caused by
bacterial invasion via the lymphatic or
vascular system

65.  Nausea and vomiting
 Inidgestion
 Belching
 Flatulence
 Epigastric pain that radiates to the scapula
2 to 4 hours after eating fatty foods and
may persist for 4 to 6 hours

66.  Pain localized in the right upper
quadrant
 Guarding, rigidity, and rebound
tenderness
 Mass palpated in the right upper
quadrant
 Murphy’s sign

67.  Elevated temperature
 Tachycardia
 Signs of dehydration
 Jaundice
 Dark orange and foamy urine
 Steatorrhea and clay-colored feces

68.  Maintain NPO status during nausea and
vomiting episodes
 Maintain nasogastric decompression as
prescribed for severe vomiting
 Administer antiemetics as prescribed
 Administer analgesics as prescribed
(morphine sulfate and codeine sulfate are
avoided)

69.  Administer antispasmodics as prescribed
to relax smooth muscles
 Instruct the client with chronic
cholecystitis to eat small, low-fat meals
 Instruct the client to avoid gas forming
foods
 Prepare the client for surgical
interventions

70.  Cholecystectomy – is the removal of the
gallbladder
 Choledocholithotomy – requires incision
into the common bile duct to remove
the stone
 Surgical procedures may be performed
by laparoscopy

71.  Monitor for respiratory complications
caused by pain at the incisional site
 Encourage coughing and deep breathing
 Encourage early ambulation
 Instruct the client about splinting the
abdomen to prevent discomfort during
coughing

72.  Administer antiemetics as prescribed for
nausea and vomiting
 Administer analgesics as prescribed for
pain relief
 Maintain NPO status and nasogastric
tube suction as prescribed
 Advance diet from clear liquids to solids
when prescribed as tolerated by the
client

73.  Maintain and monitor drainage from the
T tube, if present

74.  A T tube is placed after surgical
exploration of the common bile duct.
The tube preserves patency of the duct
and ensures drainage of bile until
edema resolves and bile is effectively
draining into the duodenum]
 A gravity drainage bag is attached to
the t tube to collect the drainage

75.  Position the client in a semi-Fowler’s
position to facilitate drainage
 Monitor the amount, color, consistency,
and odor of the drainage
 Report sudden increases in bile output to
the physician
 Monitor for inflammation and protect the
skin from irritation

76.  Keep the drainage system below the
level of the gallbladder
 Monitor for foul odor and purulent
drainage and report its presence to the
physician
 Avoid irrigation, aspiration, or clamping
of the T tube without a physician’s order

78.  Inflammation of the pancreas appears
to be caused by a process called
autodigestion
 Commonly associated with excessive
alcohol consupmtion

79.  Abdominal pain (midepigastric or left
upper quadrant) with radiation to the
back
 Pain aggravated by a fatty meal or
alcohol
 Abdominal tenderness and guarding

80.  Nausea and vomiting
 Weight loss
 Cullen’s signs
 Turner’s sign
 Absent or decreased bowel sounds

81.  Elevated WBC, glucose, and bilirubin
 Elevated serum lipase and amylase
levels

82.  Maintain NPO status and maintain
hydration with IV fluids as prescribed
 Administer parenteral nutrition for severe
nutritional depletion
 Administer supplemental preparations
and vitamins and minerals to increase
caloric intake if prescribed

83.  Maintain nasogastric tube to decrease
gastric distention and suppress
pancreatic secretion
 Administer meperidine hydrochloride as
prescribed for pain
 Administer antacids as prescribed
 Administer H2 receptor antagonists as
prescribed

84.  Administer anticholinergics as prescribed
 Instruct the client in the importance of
avoiding alcohol
 Instruct the client in the importance of
follow-up visits with the physician
 Instruct the client to notify the physician if
acute abdominal pain, jaundice, clay-
colored stools, or dark colored urine
develops

86.  Continual inflammation and destruction
of the pancreas, with scar tissue
replacing pancreatic tissue
 The acinar, or enzyme-producing cells of
the pancreas ulcerate in response to
inflammation

87.  Abdominal pain and tenderness
 Left upper quadrant mass
 Steatorrhea and foul-smelling stools that
may increase in volume
 Weight loss
 Muscle wasting
 Jaundice

88.  Instruct client to limit fat and protein
intake
 Instruct the client to avoid heavy meals
 Instruct the client about the importance
of avoiding alcohol
 Provide supplemental preparations

89.  Administer pancreatic enzymes as
prescribed
 Administer insulin and oral hypoglycemic
agents as prescribed
 Instruct the client in the importance of
follow-up visits

91.  Also known as gluten enteropathy or
celiac sprue
 Intolerance to gluten, the protein
component of wheat, barley, rye, and
oats
 Results in the accumulation of the amino
acid glutamine, which is toxic to
intestinal mucosal cells

92.  Intestinal villi atrophy occurs, which
affects absorption of ingested nutrients

93.  Acute or insidious diarrhea
 Steatorrhea
 Anorexia
 Abdominal pain
 Muscle wasting

94.  Vomiting
 Anemia
 Irritability

95.  Maintain a gluten-free diet, substituting
corn and rice as grain sources
 Instruct parents and child about lifelong
elimination of gluten sources such as
wheat, rye, oats, and barley
 Administer mineral and vitamin
supplements

96.  Teach client about a gluten-free diet
and about reading food labels carefully
for hidden sources of gluten

98.  React with gastric acid to produce
neutral salts or salts of low acidity
 Inactivate pepsin and enhance mucosal
protection but do not coat the ulcer
crater
 Taken 1 t0 3 hours after each meal

99.  Should be chewed thoroughly and
followed with a glass of milk or water
 Aluminum hydroxide preprations
 Calcium carbonate (Tums)
 Magnesium hydroxide preparations
 Sodium bicarbonate

100.  Misoprostol (Cytotec)
› Suppresses secretion of gastric acid
› Promotes secretion of bicarbonate and
cytoprotective mucus
 Sucralfate (Carafate)
› Creates a protective barrier against acid
and pepsin

101.  Cimetidine (Tagamet)
› Food reduces rate of absorption
 Ranitidine (Zantac)
› Not affected by food
 Famotidine (Pepcid)
› Not affected by food

102.  Suppress gastric acid secretion
 Headache, diarrhea, abdominal pain,
and nausea
 Esomperazole (Nexium), Lansoprazole
(Prevacid), Omeprazole (Prilosec)

103.  To control vomiting and motion sickness
 Monitor for drowsiness and protect the
client from injury
 Ondansetron (Zofran), Metoclopramide
(Reglan), Promethazine hydrochoride
(Phenergan)