FASTING BLOOD SUGAR AND BARIUM SWALLOW

DEPARTMENT OF NURSING
3RD COHORT

BY

GROUP 4

COURSE TITLE AND CODE: FOUNDATION OF NURSING IV

GNS211

MAY, 2023.
 GROUP MEMBERS

S/N GROUP MEMBERS MAT NUMBER

1 Jamani Faith Omokhose 00233

2 Idehen Jonathan 00227

3 Obaidiku Daniel 00282

4 Ahakon Ideiyemi 00236

5 Okoh Diana 00235

6 Osaro Becky 00231

7 Ehioghae Praise Aisosa 00229

8 Abdulrahman Fadhilatu 00232

9 John Osasenaga Judith 00301

10 Ogaluonye Precious 00288

11 Akpovire-Akpobi QueenEsther 00228

12 Masade Ebehireme Matilda 00234

13 Edenojie Omotese 00143

 FASTING BLOOD SUGAR

INTRODUCTION

Fasting blood sugar is a test that measures the amount of glucose in the blood after an
overnight fast of at least eight hours. The test is used to screen for diabetes, prediabetes and
gestational diabetes. Fasting blood sugar levels are measured in milligrams per deciliter (mg/dL).
Fasting blood sugar is a reliable indicator of whether or not you have diabetes. Fasting blood sugar
levels can be measured by a fasting plasma glucose (FPG) test, which is a simple, accurate and
inexpensive test that can screen for diabetes and insulin functioning problems.

IMPORTANCE OF FASTING BLOOD SUGAR IN DIAGNOSING AND MONITORING DIABETES:

1. Early detection: Fasting blood sugar helps detect diabetes early, allowing for timely treatment
and prevention of complications.
2. Monitoring blood sugar control: Regular fasting blood sugar tests help monitor how well
diabetes treatment plans are working.
3. Adjusting medication: Fasting blood sugar results help healthcare providers adjust medication
dosages or change treatment plans as needed.
4. Identifying hypoglycemia: Fasting blood sugar tests can detect hypoglycemia (low blood sugar)
and help prevent severe episodes.
5. Screening for gestational diabetes: Fasting blood sugar tests are used to screen for gestational
diabetes in pregnant women.
6. Monitoring diabetes during pregnancy: Regular fasting blood sugar tests help monitor blood
sugar control during pregnancy, reducing the risk of complications.
7. Assessing risk for complications: Fasting blood sugar levels can indicate the risk of developing
diabetes-related complications, such as kidney disease or nerve damage.

PURPOSE OF FASTING BLOOD SUGAR TEST

1. Diagnosis of Diabetes and Prediabetes: Fasting blood sugar tests are primarily used to
diagnose diabetes mellitus and prediabetes. Diabetes is a condition characterized by high levels
of glucose (sugar) in the blood, either due to inadequate insulin production or the body's
inability to use insulin effectively. Prediabetes is a condition where blood sugar levels are
higher than normal but not high enough to be classified as diabetes. By measuring fasting
blood sugar levels, healthcare providers can identify individuals at risk for these conditions.
 2. Monitoring Diabetes Management: For individuals already diagnosed with diabetes, fasting
blood sugar tests are a crucial tool for monitoring blood glucose levels and assessing the
effectiveness of diabetes management strategies, including diet, exercise, medication, and
insulin therapy. Consistently high fasting blood sugar levels may indicate inadequate diabetes
control and the need for adjustments in treatment.

3. Assessment of Overall Health: Fasting blood sugar levels can provide valuable insights into a
person's overall health. Elevated fasting blood sugar levels may be indicative of insulin
resistance, a precursor to type 2 diabetes, as well as other metabolic disorders such as
metabolic syndrome. Additionally, persistently high blood sugar levels can increase the risk of
complications such as cardiovascular disease, nerve damage, kidney disease, and vision
problems.

4. Risk Assessment for Complications: Regular monitoring of fasting blood sugar levels can help
healthcare providers assess an individual's risk of developing complications associated with
diabetes, such as diabetic retinopathy (damage to the blood vessels in the retina), diabetic
neuropathy (nerve damage), and diabetic nephropathy (kidney damage). Early detection of
elevated blood sugar levels allows for proactive management and preventive measures to
reduce the risk of complications.

5. Evaluation of Lifestyle Interventions: Fasting blood sugar tests are often used to evaluate the
impact of lifestyle interventions, such as dietary changes and increased physical activity, on
blood sugar control. For individuals with prediabetes or early-stage diabetes, lifestyle
modifications may help prevent or delay the progression of the disease. Monitoring fasting
blood sugar levels over time can indicate whether these interventions are effective in
improving glucose regulation.

PREPARATION FOR FASTING BLOOD SUGAR (GLUCOSE) TEST

This preparation involves the following procedures;

1. Fasting period: Avoid food and drinks for at least 8 hours, preferably 10-12 hours before the
test.
2. Water intake: Avoid excessive water consumption.
3. Medications: Inform your healthcare provider about any medications you are taking. Some
medications might need to be stopped or adjusted before the test.
4. Avoid strenuous activities: Refrain from any physical activities that might affect blood sugar
(glucose) level.
5. No smoking: Avoid smoking and tobacco product before the test.
6. Relaxation: Try to relax and minimize stress, as it can affect blood sugar (glucose) level.
7. Collection procedure: A healthcare professional will collect a blood sample from a vein in your
arm using a sterile needle and syringe.
8. Sample handling: The collected blood sample will be sent to a lab for laboratory analysis.

PROCEDURE FOR FASTING BLOOD SUGAR

To prepare for a fasting glucose test, the client would have nothing to eat or drink (except
water) for 8 to 12 hours, most preferably should be scheduled first thing in the morning so that
client wouldn’t have to fast during the day. It can be done in two ways:

1. Finger-Prick test

Blood glucose level can be monitored using a glucometer, following these steps:

 Wash hands thoroughly with soap and water. Dry well.

 Use the lancet device that came with kit to prick the side of a fingertip.

 Touch the edge of a test strip to the drop of blood that arises after the finger prick.

 Place the strip in the meter.

 Track and record results.

 Dispose of the lancet and the meter

2. Blood-drawn test:

This is done by taking a sample of blood to test:

The procedure is as follows:

 Clean the area with an antiseptic, like alcohol, to kill any germs.

 Tie an elastic band around upper arm, causing veins to swell with blood.

 Insert a sterile needle into a vein. Client may feel slight to moderate pain when the
needle goes in, but pain can be reduced by relaxing the arm.

 Blood is then drawn into a tube attached to the needle.

 Remove needle and place a bandage over the punctured site.

 Apply Pressure to the punctured site for a few minutes to prevent bruising.
Result Interpretation

The results of the fasting blood sugar test will come back as a number:

 99 mg/dL or lower: Indicates a normal fasting blood sugar level.

 100–125 mg/dL: Fasting blood sugar in this range typically indicates prediabetes.

 126 mg/dL or above: This indicates high blood sugar, the main sign of diabetes.

FACTORS CAN INFLUENCE FASTING BLOOD SUGAR LEVEL

1. Diet: The types and amounts of carbohydrates, fats, and proteins consumed can impact
blood sugar levels.
2. Physical activity: Regular exercise can help regulate blood sugar levels by improving insulin
sensitivity.
3. Medications: Certain medications, such as corticosteroids and some antidepressants, can
affect blood sugar levels.
4. Stress: Stress hormones can cause blood sugar levels to rise.
5. Sleep: Poor sleep patterns can affect insulin sensitivity and glucose metabolism.
6. Illness: Infections and other illnesses can cause blood sugar levels to fluctuate.
7. Genetics: Family history and genetic predisposition can play a role in blood sugar regulation.
8. Hormonal changes: Hormonal fluctuations, such as those during puberty, pregnancy, or
menopause, can affect blood sugar levels.
9. Alcohol consumption: Alcohol can interfere with liver function, affecting blood sugar
regulation.
10. Weight: Being overweight or obese can increase insulin resistance, leading to higher blood
sugar levels.

RISK FACTORS FOR FASTING BLOOD SUGAR

1. Family history of diabetes
2. Being overweight or obese
3. Sedentary lifestyle
4. High blood pressure
5. High cholesterol levels
6. Age (risk increases with age)
7. Certain ethnic backgrounds (such as African, Hispanic, or Asian)
8. Gestational diabetes during pregnancy
9. Polycystic ovary syndrome (PCOS)
10. History of heart diseases
 NURSING IMPLICATIONS FOR FASTING BLOOD TEST PREPARATION
In hospital, it is usually the responsibility of the nurse to perform blood glucose readings. Prior
to performing a blood glucose test, ensure that you have read and understood the
manufacturer’s instruction. It is also important that you determine the patient’s understanding
of the procedure and the purpose for monitoring blood glucose level.
For a fasting blood glucose test, the patient can’t eat or drink anything except water for 8 hours
before your test. You may want to schedule a fasting glucose test first thing in the morning so
that you don’t have to fast during the day.
Fasting before a blood glucose test is important because it’ll provide more accurate results that
are easier for your doctor to interpret.

BARIUM SWALLOW
INTRODUCTION

"A barium swallow, also known as an Esophagram or Esophagogram, is a diagnostic imaging

test used to evaluate the upper gastrointestinal tract, specifically the throat, esophagus, and
stomach. This test is essential for diagnosing and managing various conditions affecting the
swallowing mechanism, including dysphagia, gastroesophageal reflux disease (GERD), and
structural abnormalities such as tumors, ulcers, and narrowing of the esophagus. During the
test, a patient drinks a barium-containing liquid that coats the inner lining of the throat,
esophagus, and stomach, allowing for clear visualization of these structures on X-ray images.
The barium swallow test is a valuable tool for healthcare professionals to assess and manage
various conditions affecting the upper gastrointestinal tract, and this presentation/report will
delve into its uses, procedure, and significance in medical practice."

DEFINITION
A barium swallow, also called an Esophagram or esophagogram, is a type of imaging test that
helps doctors check for problems in your upper GI tract, which includes your mouth, back of
the throat, esophagus, stomach and the first part of your small intestine ¹. The test uses X-ray
fluoroscopy and involves drinking a chalky-tasting liquid that contains barium, a substance that
makes parts of your body show up more clearly on an X-ray.

SIDE EFFECTS OF BARIUM SWALLOW.

Some of the side effects of barium swallow include:
1. Nausea
2. Constipation
3. Diarrhea
4. Stomach cramps
5. Bloating
6. White stools
7. Abdominal pain
8. Blood in the urine or stools
9. Fast or slow heartbeat
10. Dizziness or faintness
11. Anxiety
12. Chest pain
13. Bruising
14. Coughing or vomiting blood
15. Unusual tiredness or weakness

PRECAUTIONS FOR BARIUM SWALLOW.

1. Tell your doctor if you have any allergies (especially to barium or iodine).
2. Inform your doctor about any medications you are taking.
3. Inform your doctor if you are pregnant.
4. Don't eat or drink anything the night before the test.
5. Drink plenty of liquids during and after the test.
6. Follow a liquid diet for a few hours to help the barium move through your digestive system.
7. Avoid eating solid foods until the barium has passed through (stools will return to normal
color).

CONTRAINDICATIONS.
1. Pregnancy or suspected pregnancy: Barium swallow is not recommended during pregnancy,
especially in the first trimester, as the radiation may harm the developing fetus.
2. Breastfeeding: Barium may be excreted in breast milk, and the procedure is usually delayed
until breastfeeding is discontinued.
3. Gastrointestinal obstruction or perforation: Barium swallow is contraindicated in patients
with a known or suspected gastrointestinal obstruction or perforation, as it may exacerbate
the condition.
4. Inflammatory bowel disease: Patients with active inflammatory bowel disease (IBD) may be
at increased risk of complications from the procedure.
5. Allergy to barium: A history of allergic reactions to barium or any component of the contrast
agent is a contraindication.
6. Respiratory insufficiency: Patients with severe respiratory problems may be at risk of
aspiration or respiratory failure during the procedure.
7. Recent gastrointestinal surgery: Barium swallow may be delayed for several weeks after
gastrointestinal surgery to allow for proper healing.
8. Active gastrointestinal bleeding: The procedure may exacerbate bleeding or mask the
symptoms of active bleeding.

PURPOSE OF BARIUM SWALLOW

Barium swallow is a medical imaging test used to evaluate the esophagus, stomach, and small
intestine. Its purposes include:
1. Diagnosing swallowing disorders (dysphagia)
2. Detecting ulcers, tumors, and inflammation in the digestive tract
3. Identifying structural abnormalities, such as narrowing or blockages
4. Monitoring the progression of digestive diseases, like gastroesophageal reflux disease
(GERD)
5. Guiding treatment and monitoring the effectiveness of interventions

PROCEDURE FOR BARIUM SWALLOW

Generally, a barium swallow test involves the following process:
1. Patient will be asked to remove any clothing, jewelry, or other objects that may get in the
way of the swallowing test.
2. Patient may be asked to remove clothing. If so, you will be given a gown to wear.
3. Patient will lie on an X-ray table that can move you from a horizontal to an upright position,
and may also be asked to change positions during the swallowing test. For example, you may
need to lie on your side, back, or stomach.
4. The radiologist may take X-rays of your chest and belly (abdomen) first.
5. The radiologist will ask patient to take a swallow of a thick, chalky barium drink. The barium
is usually flavored, but it may not taste very good.
6. As you swallow the barium, the radiologist will take single pictures, a series of X-rays, or
fluoroscopy to watch the barium moving through your mouth and throat.
7. You may be asked to hold your breath at certain times during the test.
8. Patient will be given a thinner barium drink to swallow. The radiologist will use X-rays or
fluoroscopy to watch the barium go down your esophagus. You may also be asked to swallow
a barium tablet. This is a small pill that can help to show certain problems in the esophagus.
8. Once the radiologist has taken all of the X-rays, patient will be helped from the table.

NURSING IMPLICATIONS FOR BARIUM SWALLOW

1. The nurse must thoroughly explain the procedure to the patient, addressing any
 concerns and obtaining informed consent. This involves discussing the purpose of the
test, the preparation required, and what the patient can expect during the examination.

2. The nurse is responsible for preparing the patient adequately. This includes providing
clear instructions on fasting requirements, typically eight hours before the test, to
ensure the stomach is empty and the barium can be visualized effectively.

3. The nurse should assess the client’s medical history, allergies, and current medications
to identify potential contraindications or risks.

4. The nurse collaborates with the radiology team to position the patient comfortably and
securely on the X-ray table.

5. The nurse must ensure the correct dosage is provided, and they should explain that the
barium may have a chalky taste and may cause temporary bloating.

6. Monitoring the patient closely for any adverse reactions to the contrast medium is
crucial, and the nurse should be prepared to manage any potential allergic reactions
promptly.

7. The nurse should coordinate with the radiologist to obtain clear and accurate images
during the examination.

8. The nurse continues to monitor the patient’s condition, looking for any signs of adverse
reactions to the barium. They should provide post-procedure care instructions, such as
encouraging hydration to help the body eliminate the contrast medium and inform the
patient when they can resume a regular diet.

9. They must record the patient’s medical history, the procedure details, the patient’s
response to the test, any complications, and post-procedure care instructions. Accurate
and thorough documentation ensures proper continuity of care and assists in the
patient’s overall treatment plan.

CONCLUSION
To manage diabetes, it is important to monitor and maintain healthy fasting blood sugar levels.
People who have diabetes or pre-diabetes need to test their blood sugar levels regularly and
record their results. They should talk with a doctor if they notice any changes or unusual
symptoms. Fasting blood sugar is a crucial indicator of glucose metabolism and is used to
diagnose and manage diabetes. Monitoring fasting blood sugar levels helps evaluate overall
glucose control and guides treatment strategies. Maintaining normal fasting blood sugar levels
through medication, diet, and lifestyle changes is essential for preventing complications
associated with diabetes.

A barium swallow is a valuable diagnostic tool for evaluating upper gastrointestinal conditions.
By utilizing barium contrast material and X-ray imaging, healthcare providers can assess the
structure and function of the esophagus, stomach, and small intestine, aiding in the diagnosis
of various disorders. While generally safe and effective, it's crucial for patients to follow pre-
test instructions and communicate any relevant medical information to their healthcare team.
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