Upper and Lower GI Series Diagnostic Procedures

Barium is a radio-opaque substance that appears like "milk" or chalky white soultion, that constipates the stool.


UPPER GI SERIES (Barium Swallow)
Ingestion of Barium sulfate to outline esophagus and stomach (duodenum too) as well as its physiology, by radiologic (x-ray) examinations

Nursing Implications:
- NPO post midnight
- Encourage fluids to facilitate elimination
- Laxatives as ordered
- Advise for light (clay) colored constipated stool
LOWER GI SERIES (Barium Enema)
Instillation (by enema) of barium, positioning the client for radiologic examinations

Nursing Implications:
- Light diet and Laxative evening prior to test
- Cleansing Enema prior, followed by barium enema, then by series of x-rays, and cleansing enema (to prevent impaction)

****In case both barium swallow and barium enema will be done at one setting, barium enema is done first. !!

Nursing Implications on Gastric Diagnostic Procedures

GASTROSCOPY
Direct Visualization of the esophagus and the stomach using a lighted flexible tube.

Nursing Implications:
- NPO post midnight or at least 8 hours prior to the procedure and maintain NPO until gag reflex returns.
- Anesthesia, by a spray or gargle, may lead to sore throat for 4 days after the procedure
- Observe hematemesis and respiratory distress

PROCTOSCOPY SIGMOIDOSCOPY
Direct Visualization of the sigmoid colon and the anal canal

Nursing Implications:
- Laxative night before exam, NPO from midnight and enema or suppository in the morning of the procedure


COLONOSCOPY
Direct Visualization of the colon

Nursing Implication:
- Clear Liquid 1 to 3 days prior
- Cathartics for 2 nights prior
- Enema in am of exam
- Observe stool and vital signs

GASTRIC ASPIRATION
Insertion of nasogastric tube and aspiration of gastric of gastric content for laboratory analysis of abnormal constituents (blood, bacteria, malignant cells) and pH.

Nursing Implications:
- NPO at least 6 hours before the test
- Send aspirate to laboratory for test
- Histamine is someties ordered to stimulate HCL production (achlorydia - no HCL production is a findings in Pernicious Anemia)
- Occult blood test (Guaiac Test) may also be used to detect presence of blood in the aspirate (as it is also a test for occult blood in the stool)