THYROID FUNCTION TESTS THYROID SCAN

➢ DIAGNOSTIC PROCEDURE
➢ DIAGNOSTIC PROCEDURE
PREPARATION
BLOOD TESTS
• Inform the patient about the procedure,
• Thyroid-Stimulating Hormone (TSH): Measures
including its purpose, benefits, and potential
the level of TSH, which is produced by the pituitary
risks.
gland and regulates thyroid hormone production.
• Verify the patient's medical history, including
• Thyroxine (T4): Measures the total or free thyroxine
any allergies, previous radiation exposure, or
levels in the blood. Elevated T4 indicates
thyroid disorders.
hyperthyroidism, while decreased T4 suggests
hypothyroidism. ADMINISTRATION OF RADIOACTIVE
• Thyroid Antibodies: Tests such as thyroid
• Position the patient comfortably on the imaging
peroxidase antibodies (TPOAb) and thyroglobulin
table, ensuring proper alignment for accurate
antibodies (TgAb) help diagnose autoimmune
scanning.
thyroid diseases like Hashimoto's thyroiditis and
Graves' disease. • Acquire images of the thyroid gland using a
gamma camera or scintillation detector,
• Thyroglobulin: Measures levels of thyroglobulin, a
capturing both anterior and posterior views for
protein produced by the thyroid gland. Elevated
comprehensive evaluation.
thyroglobulin levels may indicate thyroid cancer
➢ NURSING RESPONSIBILITIES
recurrence.
• Explain the importance of following pre-scan
RADIOACTIVE IODINE UPTAKE TESTS instructions, such as fasting and medication
restrictions, to optimize scan results.
• Involves administering a small amount of
• Ensure compliance with institutional radiation
radioactive iodine orally and measuring the
safety protocols and guidelines for handling
amount absorbed by the thyroid gland.
radioactive materials and performing nuclear
• High uptake indicates hyperthyroidism, while low
medicine procedures.
uptake suggests hypothyroidism or thyroiditis.
• Address any discomfort or concerns the patient
THYROID ULTRASOUND may experience during the scanning process,
such as claustrophobia or difficulty remaining
• evaluate thyroid size, detect nodules, and assess
still.
for structural abnormalities.
• Document the patient's pre-scan preparation,
BIOPSY administration of the radioactive tracer, and
scanning procedure in the medical record.
• evaluate thyroid nodules for cancerous or benign
characteristics.
• obtain tissue samples for examination.
➢ NURSING RESPONSIBILITIES
• Educate patients about the purpose of thyroid
function tests, including the importance of
accurate diagnosis and monitoring of thyroid
disorders.
• Assist with blood sample collection, ensuring
proper labeling and handling of specimens.
• Monitor patients for any adverse reactions or
complications following blood tests or
procedures.
• Teach patients about the importance of
medication adherence and regular follow-up
appointments for monitoring thyroid function and
treatment response.
PARATHYROID FUNCTION TESTS
➢ DIAGNOSTIC PROCEDURE
SERUM CALCIUM LEVELS
• Measurement of total serum calcium levels
provides an initial assessment of calcium
metabolism.
• Hypocalcemia (low calcium levels) may indicate
hypoparathyroidism, while hypercalcemia (high
calcium levels) may suggest hyperparathyroidism.
PARATHYROID HORMONE(PTH) LEVELS
• Elevated PTH levels may indicate primary
hyperparathyroidism, while decreased PTH levels
may suggest hypoparathyroidism.
CALCIUM PHOSPHATE METABOLISM TESTS
• serum phosphate levels and urinary calcium
excretion may provide additional information
about calcium-phosphate metabolism and
parathyroid function.
IMAGING STUDIES
• ultrasound, computed tomography (CT), or
magnetic resonance imaging (MRI) may be used to
localize parathyroid glands and evaluate for
abnormalities such as adenomas or hyperplasia.
➢ NURSING RESPONSIBILITIES
• Educate the patient about the purpose of
parathyroid function tests, including their role in
diagnosing and monitoring parathyroid disorders.
• Assist with specimen collection for blood tests,
ensuring proper labeling and handling of
specimens to maintain sample integrity.
• Discuss the importance of follow-up
appointments with healthcare providers to review
test results, discuss treatment options, and
monitor progress.
• Document the patient's pre-test preparation,
specimen collection procedures, and test results
in the medical record.
ADRENAL MEDULLARY DISORDER TEST
➢ DIAGNOSTIC TEST
PLASMA/URINARY METANEPHRINES AND
CATECHOLAMINES
• Measurement of metanephrines (metabolites
of catecholamines) and catecholamines
(epinephrine, norepinephrine, and dopamine)
in plasma or urine.).
• elevated levels of metanephrines and
catecholamines are indicative of adrenal
medullary disorders, such as
pheochromocytoma or paraganglioma.
24 HOUR URINARY FRACTIONATED METANEPHRINES
• Collection of a 24-hour urine sample for
measurement of fractionated metanephrines
(normetanephrine and metanephrine).
PLASMA FREE METANEPHRINES
• Measurement of plasma-free metanephrines
(normetanephrine and metanephrine) is a
highly sensitive test for detecting
pheochromocytoma.
• Elevated levels of plasma-free metanephrines
indicate the presence of a catecholamine-
secreting tumor.
CT SCAN OR MRI OF THE ADRENAL GLANDS
• visualize adrenal tumors and assess for their
location, size, and characteristics.
➢ NURSING RESPONSIBILITIES
• Educate patients about the purpose of
diagnostic tests, including plasma or urinary
metanephrines, imaging studies, and
scintigraphy.
• avoidance of caffeine-containing foods)
before urine collection for metanephrines
testing.
• Instruct patients on proper techniques for
collecting urine specimens for 24-hour
metanephrines testing to ensure accurate
results.
• Ensure timely and proper collection and
processing of urine specimens to maintain
sample integrity.
• Monitor patients for signs and symptoms of
hypertensive crises, such as severe
headaches, palpitations, sweating, and
hypertension, during diagnostic testing.
• Implement safety measures to prevent
hypertensive crises during diagnostic
procedures, such as ensuring availability of
antihypertensive medications and emergency
equipment.
 ➢ DIAGNOSTIC TESTS
ADRENOCORTICAL DISORDER BLOOD TEST

• Cortisol Levels: Measurement of serum cortisol levels helps

➢ CUSHING SYNDROME
CAUSES
• prolonged exposure to high levels of cortisol,
either due to excessive production by the
adrenal glands (adrenal Cushing's syndrome)
or prolonged use of corticosteroid
medications (iatrogenic Cushing's syndrome).
SYMPTOMS
assess adrenal function. Elevated cortisol levels may indicate
Cushing's syndrome, while low levels may suggest adrenal
insufficiency (Addison's disease).
• ACTH Levels: Adrenocorticotropic hormone (ACTH) stimulates
cortisol production by the adrenal glands. Measurement of ACTH
levels can help differentiate between primary and secondary
adrenal insufficiency.
• Aldosterone and Renin Levels: Evaluation of serum aldosterone
and renin levels helps diagnose primary hyperaldosteronism
(Conn's syndrome).
URINE TESTS

•Weight gain (especially around the abdomen)
• muscle weakness
•thinning of the skin
•easy bruising, facial rounding (moon face)
• buffalo hump (accumulation of fat between
the shoulders)
• 24-Hour Urinary Free Cortisol: Measurement of
cortisol levels in a 24-hour urine sample helps assess
cortisol production over an extended period. Elevated
levels may indicate Cushing's syndrome.
• Urinary Metanephrines: Measurement of metanephrines
in urine helps diagnose pheochromocytoma, a rare
adrenal tumor that produces excess catecholamines.

• Hypertension ACTH STIMULATION TESTS

• glucose intolerance, and osteoporosis.
• This test assesses the adrenal glands' ability to respond to
➢ ADDISON’S DISEASE ACTH stimulation by measuring cortisol levels before and
after the administration of synthetic ACTH (cosyntropin). A
CAUSES subnormal cortisol response may indicate adrenal
• Primary adrenal insufficiency resulting from insufficiency.
IMAGING STUDIES
damage to the adrenal glands, typically due to
• Iodine-131 Metaiodobenzylguanidine (MIBG)
autoimmune destruction, infections (e.g., Scintigraphy: This nuclear medicine imaging technique
tuberculosis), or adrenal hemorrhage. is used to detect and localize adrenal
pheochromocytomas.
SYMPTOMS DEXAMETHASONE SUPRESSION TEST
• evaluates cortisol suppression in response to
• Fatigue dexamethasone administration. Different protocols
• weight loss. (e.g., low-dose overnight, high-dose suppression) are
• muscle weakness used to differentiate between various forms of
Cushing's syndrome.
• hyperpigmentation (bronzing of the skin)
PAC/PRA
• Hypotension • This ratio is calculated to diagnose primary
• salt craving. hyperaldosteronism (Conn's syndrome). A high
• nausea, vomiting, and abdominal pain. PAC/PRA ratio suggests primary hyperaldosteronism
due to aldosterone excess.
➢ CONN’S SYNDROME
ADRENAL VENOUS SAMPLING
• AVS is an invasive procedure used to localize
CAUSES aldosterone-producing adenomas in primary
• Excessive production of aldosterone by the hyperaldosteronism. It involves sampling blood from the
adrenal veins to compare aldosterone levels on each
adrenal glands, often due to adrenal
side.
adenomas or hyperplasia.
➢ NURSING RESPONSIBILITIES
SYMPTOMS • Monitor vital signs, fluid and electrolyte balance, and
signs of adrenal crisis (e.g., hypotension, dehydration) in
• Hypertension (often resistant to patients with adrenal insufficiency.
antihypertensive medications) • assess for signs of Cushing's syndrome (e.g., weight
gain, hypertension) or Conn's syndrome (e.g.,
• muscle weakness
hypertension) in at-risk individuals.
• fatigue, headaches • Administer corticosteroid replacement therapy (e.g.,
• polyuria (excessive urination). hydrocortisone, prednisone) as prescribed for patients
with adrenal insufficiency.
• Monitor for side effects of corticosteroid therapy, such
as osteoporosis, glucose intolerance, and
immunosuppression.
• importance of medication adherence, including the
need for glucocorticoid and mineralocorticoid
replacement therapy in Addison's disease.
• Provide guidance on stress management, dietary
considerations (e.g., sodium intake), and recognition of
signs and symptoms of adrenal crisis.
PANCREATIC DISORDER TEST
➢ DIAGNOSTIC TEST
BLOOD TEST
• Amylase and Lipase Levels: Measurement of
serum levels of amylase and lipase, enzymes
released by the pancreas. Elevated levels
indicate pancreatic inflammation, such as
acute pancreatitis.
• Pancreatic Enzyme Levels: Measurement of
pancreatic enzyme levels, including trypsin,
chymotrypsin, and elastase, may help
diagnose pancreatic insufficiency.
IMAGING STUDIES
➢ NURSING RESPONSIBILITIES
• Educate patients about the purpose and
procedures of diagnostic tests, including
blood tests, imaging studies, and
endoscopic procedures.
• Provide instructions on pre-test preparation,
such as fasting requirements for blood tests
or bowel preparation for imaging studies.
• Ensure patient compliance with bowel
preparation instructions for imaging studies
requiring clear visualization of the pancreas.
• Monitor patients for pain or discomfort
during invasive procedures, such as ERCP or
EUS-FNA, and provide appropriate
interventions (e.g., pain management).

• Abdominal Ultrasound: Uses sound waves

to visualize the pancreas and detect
abnormalities, such as pancreatic masses,
cysts, or inflammation.
• Computed Tomography (CT) Scan: Provides
detailed cross-sectional images of the
pancreas and surrounding structures, aiding
in the diagnosis of pancreatic cancer,
pancreatitis, and other pancreatic disorders.
• Magnetic Resonance Imaging (MRI): Offers
detailed images of the pancreas and adjacent
organs, particularly useful for evaluating
pancreatic ductal anatomy and detecting
tumors or structural abnormalities.
• Endoscopic Retrograde
Cholangiopancreatography (ERCP): Invasive
procedure combining endoscopy and
fluoroscopy to visualize the pancreatic and
bile ducts, obtain tissue samples, and
perform interventions (e.g., stent placement).
• Endoscopic Ultrasound (EUS): Combines
endoscopy with ultrasound imaging to assess
pancreatic lesions, obtain tissue samples
(fine-needle aspiration), and stage pancreatic
cancer.
ENDOSCOPIC ULTRASOUND GUIDED FINE
NEEDLE ASPIRATION
• Minimally invasive procedure performed
during EUS to obtain tissue samples from
pancreatic lesions for cytological or
histological analysis, aiding in the diagnosis of
pancreatic cancer.
PANCREATIC FUNCTION TEST
• Fecal Elastase Test: Measures fecal elastase
levels to assess pancreatic exocrine function.
Low elastase levels suggest pancreatic
insufficiency.
• Secretin-Stimulated Pancreatic Function
Test: Measures pancreatic secretions in
response to secretin stimulation, assessing
pancreatic exocrine function.
• Serum Glucose and Insulin Levels:
Evaluation of serum glucose and insulin levels
may be performed to assess pancreatic
endocrine function and screen for diabetes
mellitus secondary to pancreatic disorders.
INSULIN THERAPY
• Instruct patients on recognizing and managing
➢ TYPES OF INSULIN hypoglycemia, including symptoms, treatment with
rapid-acting carbohydrates (e.g., glucose tablets,
RAPID ACTING INSULIN juice), and glucagon administration in severe cases.
• Insulin lispro (Humalog), insulin aspart • Educate patients on the signs and symptoms of
hyperglycemia and the importance of timely insulin
(NovoLog), insulin glulisine (Apidra).
administration and blood glucose monitoring to prevent
Onset: 10-30 minutes.
complications.
Peak: 1-2 hours.
• Assess patients' understanding of insulin therapy and
Duration: 3-5 hours. barriers to adherence, addressing concerns and providing
• Administered before meals to control support as needed.
postprandial glucose levels.

SHORT ACTING INSULIN

• Examples: Regular human insulin (Humulin R,

Novolin R).
Onset: 1-2 hours.
Peak: 4-12 hours.
Duration: 12-18 hours.
• Often used as basal insulin to provide
background insulin coverage.

LONG-ACTING INSULIN
• Examples: Insulin glargine (Lantus, Basaglar),
insulin detemir (Levemir), insulin degludec
(Tresiba).
Onset: Gradual onset over several hours.
Peak: Minimal or no peak.
Duration: Up to 24 hours.
• Provides basal insulin coverage with once-
daily or twice-daily dosing.

ADMINISTRATION METHODS

SUBCUTANEOUS INJECTION

▪ Administered into the subcutaneous tissue of the

abdomen, thigh, or upper arm using insulin syringes,
pens, or pumps.

INSULIN PUMP THERAPY

▪ Delivers continuous subcutaneous insulin infusion via

an insulin pump, providing basal insulin delivery and
bolus doses for meals.
▪ Requires regular monitoring and adjustment of insulin
doses by the patient or healthcare provider.

➢ NURSING RESPONSIBILITIES
• educate patients about insulin therapy,
including insulin types, administration
techniques, injection site rotation, and blood
glucose monitoring.
• Provide guidance on insulin dose adjustment
based on blood glucose levels, carbohydrate
intake, physical activity, and illness.
• Teach patients proper injection technique,
including site preparation, needle insertion
angle, and insulin administration.
• Emphasize the importance of maintaining
aseptic technique to prevent infections.
FOOT CARE

➢ DAILY FOOT CARE ROUTINE

•Check your feet every day for any signs of

redness, blisters, cuts, sores, swelling, or
other abnormalities.
• Wash your feet daily with lukewarm water
and mild soap.
• Avoid soaking your feet for too long, as it
can dry out the skin.
• Gently pat your feet dry, especially
between the toes.
• Apply a moisturizing lotion or cream to the
tops and bottoms of your feet but avoid
applying between the toes to prevent
excess moisture buildup.
• Cut your toenails straight across and
avoid cutting too close to the skin to
prevent ingrown toenails. Use a nail file to
smooth the edges and avoid sharp
corners.
• Choose well-fitting shoes with a wide toe
box to prevent rubbing and pressure
points.
• Avoid shoes with seams or rough areas
that can cause irritation.
• Always wear clean, dry socks made of
moisture-wicking materials, such as
cotton or moisture-wicking synthetic
blends.
• Avoid walking barefoot, even indoors, to
prevent injuries.
➢ PREVENTION TIPS
• Monitor your blood sugar levels regularly
and follow your healthcare provider's
recommendations for diabetes
management.
• Smoking can impair circulation and
increase the risk of foot complications. If
you smoke, talk to your healthcare
provider about strategies to quit.
• Keep your blood pressure and cholesterol
levels under control to reduce the risk of
cardiovascular complications that can
affect foot health.
• Engage in regular physical activity to
improve circulation and overall health.
Choose activities that are safe for your
feet, such as walking, swimming, or
cycling.
ENDOSCOPY
➢ DEFINITION
• to visualize the inside of the body's
organs and structures using an
instrument called an endoscope.
• The endoscope is a flexible tube with a
camera and light source at its tip, allowing
healthcare providers to see detailed
images of internal organs on a monitor in
real-time.
➢ USES OF ENDOSCOPY
• Esophagogastroduodenoscopy
(EGD): Used to examine the
esophagus, stomach, and duodenum
(upper GI tract) for conditions such as
ulcers, inflammation, tumors, and
bleeding.
• Colonoscopy: Allows visualization of
the entire colon and rectum for the
detection of polyps, colorectal cancer,
inflammation, and other
abnormalities.
• Flexible Sigmoidoscopy: Like
colonoscopy but focuses on the
sigmoid colon and rectum for
screening and diagnosis of colorectal
conditions.
• Bronchoscopy: Used to examine the
airways (bronchi and trachea) for
abnormalities such as tumors,
infections, inflammation, and foreign
bodies.
• Laryngoscopy: Examines the larynx
(voice box) and upper airway for
conditions affecting speech,
swallowing, and breathing.
• Cystoscopy: Visualizes the inside of
the bladder and urethra for the
diagnosis and treatment of urinary
tract disorders, such as bladder
cancer, stones, and infections.
• Ureteroscopy: Allows visualization of
the ureters (tubes that carry urine from
the kidneys to the bladder) for the
diagnosis and treatment of kidney
stones, tumors, and other conditions.
• Hysteroscopy: Examines the inside of
the uterus (endometrial cavity) for
conditions such as fibroids, polyps,
and abnormal bleeding.
• Laparoscopy: Minimally invasive
surgery used for diagnostic evaluation
and treatment of gynecological
conditions, including endometriosis,
ovarian cysts, and infertility.
➢ PROCEDURE
• Review the patient's medical history, including any
allergies, medications, and previous surgeries or
procedures.
• Provide instructions to the patient regarding fasting
requirements (usually for several hours) before the
procedure to ensure the stomach is empty.
• Administer pre-procedure medications as ordered,
such as sedatives or anxiolytics, to help the patient
relax and reduce discomfort.
• Position the patient appropriately on the
examination table, usually lying on their left side
with knees bent.
• Lubricate the tip of the endoscope and gently
insert it through the mouth
(esophagogastroduodenoscopy, EGD) or anus
(colonoscopy) into the GI tract.
• Advance the endoscope through the GI tract,
visualizing the esophagus, stomach, duodenum
(for EGD), or colon (for colonoscopy).
• Inspect the mucosal lining for abnormalities, such
as inflammation, ulcers, polyps, or tumors.
• Document the procedure findings, including any
abnormalities observed, interventions performed,
and patient tolerance/response to the procedure.
• Monitor the patient's vital signs and level of
consciousness during recovery from sedation or
anesthesia.
• Provide post-procedure instructions to the patient,
including dietary restrictions, activity limitations,
and potential side effects or complications to
watch for.
➢ NURSING RESPONSIBILITIES
• Verify informed consent for the procedure and
ensure the patient understands the risks,
benefits, and alternatives.
• Prepare the endoscopy suite and equipment,
ensuring everything is functioning properly and
ready for use.
• Monitor the patient's vital signs, oxygen
saturation, and level of consciousness
throughout the procedure.
• assist the endoscopist during the procedure
by handling equipment, providing suction, and
obtaining specimens or biopsies as needed.
• Adhere to strict aseptic technique and
infection control protocols to prevent cross-
contamination and reduce the risk of
infection.
• Monitor the patient's recovery from sedation or
anesthesia, assessing for any signs of
complications such as bleeding, perforation,
or adverse reactions.
• Document the details of the procedure,
including patient assessment, medications
administered, procedure findings,
interventions performed, and post-procedure
care provided.
BARIUM ENEMA
➢ DEFINITION
• diagnostic imaging procedure used to
examine the large intestine (colon)
and rectum using a contrast agent
called barium sulfate.
• The barium sulfate is administered
rectally as an enema, and X-ray
imaging is used to visualize the colon's
interior.
➢ USES OF BARIUM ENEMA
• Detection of Colorectal Cancer:
Barium enema can help detect
abnormalities in the colon, such as
tumors, polyps, or masses, which
may indicate colorectal cancer.
• Evaluation of Inflammatory Bowel
Disease (IBD): Barium enema can
be used to assess the extent and
severity of inflammatory bowel
diseases, such as Crohn's disease
and ulcerative colitis.
• Diagnosis of Diverticular Disease:
Diverticulosis and diverticulitis are
common conditions characterized
by the presence of diverticula
(small pouches) in the colon.
• Evaluation of Lower GI Bleeding:
In cases of lower gastrointestinal
bleeding, barium enema can help
localize the source of bleeding
➢ NURSING RESPONSIBILITIES
within the colon.
• Assessment of Colonic Motility
Disorders: Barium enema can
evaluate colonic motility and transit
time by observing the movement of
barium through the colon during
fluoroscopy.
➢ PROCEDURE
• Instruct the patient to follow a clear liquid diet
and avoid solid foods for a specified period
before the procedure.
• Administer a bowel preparation regimen, such
as laxatives or enemas, to cleanse the colon and
ensure optimal visualization during the
procedure.
• Review the patient's medical history, allergies,
and current medications to identify any
contraindications or special considerations.
• Position the patient on an X-ray table in a left
lateral decubitus position (lying on their left side)
with knees bent toward the chest.
• Provide a pillow or support under the patient's
head and a drape or sheet for modesty.
• Insert a lubricated enema tip into the patient's
rectum and slowly instill the barium sulfate
solution into the colon while monitoring the
patient's comfort and tolerance.
• Instruct the patient to hold the barium solution
and maintain the enema position for a specified
period, typically several minutes, to allow
adequate coating and filling of the colon.
• Position the X-ray machine over the patient's
abdomen and pelvis to capture images of the
colon filled with barium.
• Instruct the patient to hold their breath briefly
during image acquisition to minimize motion
artifacts and ensure clear visualization.
• Assist the patient in moving from the X-ray table
and provide support as needed to prevent
dizziness or falls.
• Encourage the patient to drink plenty of fluids to
help eliminate residual barium from the colon
and prevent dehydration.
• Monitor the patient for any adverse reactions or
complications, such as abdominal pain,
bloating, or constipation, and provide
appropriate interventions as needed.
• Provide clear instructions to the patient regarding
bowel preparation, dietary restrictions, and pre-
procedure medication administration.
• Assess the patient's comfort level throughout the
procedure and provide reassurance and
encouragement as needed.
• Verify the patient's identity and confirm the correct
procedure and patient positioning before initiating
the barium enema.
• Monitor the patient's vital signs, including blood
pressure, heart rate, and respiratory rate, before,
during, and after the procedure.
• Provide post-procedure instructions to the patient,
including dietary recommendations, activity
restrictions, and potential side effects such as
temporary changes in stool color due to residual
barium.
BARIUM SWALLOW
➢ DEFINITION
• upper gastrointestinal (GI) series or
esophagram, is a diagnostic imaging
procedure used to examine the upper GI
tract, including the esophagus, stomach,
and small intestine.
• ingestion of a contrast agent called
barium sulfate, followed by X-ray
imaging to visualize the structures and
function of the upper digestive system.
➢ USES OF BARIUM SWALLOW
•
Evaluation of Dysphagia: Barium
swallow is used to assess
swallowing function and identify
the underlying causes of dysphagia
(difficulty swallowing)
• Detection of Esophageal
Disorders: Barium swallow helps
diagnose esophageal conditions
such as gastroesophageal reflux
disease (GERD), esophagitis, hiatal
hernia, Barrett's esophagus, and
esophageal strictures.
• Detection of Small Bowel
Abnormalities: While primarily
focused on the upper GI tract,
barium swallow may visualize the
proximal small intestine, providing
clues to conditions such as Crohn's
disease.
➢ PROCEDURE
• Instruct the patient to fast for a specified
period before the procedure, typically
overnight, to ensure the stomach is empty.
• Review the patient's medical history,
allergies, and current medications to
identify any contraindications or special
considerations.
• Obtain informed consent from the patient
after explaining the purpose, risks,
benefits, and alternatives of the
procedure.
• Instruct the patient to fast for a specified
period before the procedure, typically
overnight, to ensure the stomach is empty.
• Review the patient's medical history,
allergies, and current medications to
identify any contraindications or special
considerations.
• Obtain informed consent from the patient
after explaining the purpose, risks,
benefits, and alternatives of the
procedure.
• Position the patient in various orientations (e.g.,
supine, prone, lateral) on an X-ray table to capture
images of the upper GI tract from different angles.
• Use fluoroscopy (real-time X-ray imaging) to
observe the passage of barium through the
esophagus, stomach, and small intestine,
assessing for abnormalities, strictures, or motility
disorders.
• During fluoroscopy, assess swallowing function
and esophageal motility by observing the bolus
movement through the esophagus and
coordination of swallowing reflexes.
• During fluoroscopy, assess swallowing function
and esophageal motility by observing the bolus
movement through the esophagus and
coordination of swallowing reflexes.
➢ NURSING RESPONSIBILITIES
• Prepare the patient for the barium swallow
procedure, including fasting instructions,
dietary restrictions, and pre-procedure
medication administration (if applicable).
• Ensure informed consent is obtained, and
the patient's questions or concerns are
addressed.
• Assist the radiologist or healthcare
provider during the barium swallow
procedure by providing support to the
patient, positioning assistance, and
monitoring patient comfort and safety.
• Communicate effectively with the
radiology team to ensure proper
coordination and execution of the
procedure.
• Educate the patient about the barium
swallow procedure, including its purpose,
expected duration, and potential
sensations or discomforts during the test.
• Adhere to strict aseptic technique and
infection control protocols to minimize the
risk of infection transmission during the
procedure.
• Ensure proper handling and disposal of
barium contrast materials according to
institutional guidelines.
• Monitor the patient's recovery from the
barium swallow procedure, assessing for
any adverse reactions or complications
such as allergic reactions, constipation, or
abdominal discomfort.
COLONOSCOPY
➢ DEFINITION
• used to examine the inside of the large
intestine (colon) and rectum using a
flexible tube with a camera and light
source called a colonoscope.
• evaluating various gastrointestinal (GI)
conditions and detecting abnormalities in
the colon.
➢ USES OF COLONOSCOPY
• Screening for Colorectal Cancer:
Colonoscopy is a primary screening
modality for detecting colorectal
cancer and precancerous lesions such
as adenomatous polyps, which can be
removed during the procedure to
prevent cancer development.
• Evaluation of Inflammatory Bowel
Disease (IBD): Colonoscopy is
essential for diagnosing and
monitoring inflammatory bowel
diseases such as Crohn's disease and
ulcerative colitis.
• Assessment of Lower GI Bleeding:
Colonoscopy is a valuable tool for
identifying the source of lower
gastrointestinal bleeding and
performing interventions such as
hemostasis (bleeding control)
➢ PROCEDURE
• Instruct the patient to follow a clear liquid
diet for 1-2 days before the procedure and
to complete a bowel preparation regimen
to cleanse the colon thoroughly.
• Review the patient's medical history,
allergies, and current medications to
identify any contraindications or special
considerations.
• Obtain informed consent from the patient
after explaining the purpose, risks,
benefits, and alternatives of the
procedure.
• Position the patient on an examination
table in a left lateral decubitus position
(lying on their left side) with knees bent
toward the chest.
• Lubricate the tip of the colonoscope and
gently insert it into the patient's rectum,
advancing it through the colon while
maneuvering around bends and curves.
• Inflate the colon with air or carbon dioxide
to allow better visualization of the colon's
lining and facilitate passage of the
colonoscope.
• Inspect the mucosal lining of the colon
and rectum for abnormalities such as
polyps, tumors, inflammation,
ulcerations, or bleeding.
• Perform any necessary diagnostic or therapeutic
interventions during the procedure, such as
biopsy, polypectomy (polyp removal), or tattooing
for localization.
• Document the procedure details, including
findings, interventions performed, and any
adverse events or complications encountered
during the procedure.
• Document the procedure details, including
findings, interventions performed, and any
adverse events or complications encountered
during the procedure.
➢ NURSING RESPONSBILITIES
• Prepare the patient for the colonoscopy
procedure, including bowel preparation
instructions, dietary restrictions, and pre-
procedure medications (e.g., laxatives or
sedatives).
• Ensure informed consent is obtained, and
the patient's questions or concerns are
addressed.
• Assist the endoscopist during the
colonoscopy procedure by handling
equipment, providing suction, and
assisting with patient positioning or
comfort measures.
• Monitor the patient's vital signs and level
of consciousness throughout the
procedure.
• Educate the patient about the
colonoscopy procedure, including its
purpose, expected duration, and potential
risks or complications.
• Provide emotional support and
reassurance to help alleviate anxiety or
discomfort before, during, and after the
procedure.
• Adhere to strict aseptic technique and
infection control protocols to minimize the
risk of infection transmission during the
procedure.
• Ensure proper cleaning, disinfection, and
sterilization of endoscopic equipment
according to institutional guidelines.
• Monitor the patient's recovery from
sedation or anesthesia, assessing for any
signs of complications such as bleeding,
perforation, or adverse reactions.