RAD 113 Test 5 Study Guide
Used as a contrast medium in radiography of the digestive tract.
Has high atomic number for optimum contrast and may be premixed or powder.
Plastic or rubber tubes inserted through the nasopharynx into the stomach.
Can be single or double lumen type.
Nasogastric (NG) tubes
Most common NG tube used for gastric decompression.
Position of patient when inserting a NG tube.
Hight Fowler position
Has unique wedge-shape design and allows patient to elevate hips only slightly for placement.
Used for bowel cleansing and to promote defecation.
Different ways the colon can be viewed (all views require colon to be free of fecal matter).
- Virtual Colonoscopy
- Barium Enema
Procedure that is performed by a gastroenterologist or surgeon. Used to see inside the entire colon and rectum. Typically takes about 30 minutes.
Procedure that is a minimally invasive alternative to conventional colonoscopy that screens the colon and rectum for polyps and early cancer before symptoms occur. Typically takes about 5 minutes and is performed in CT.
Involves no scopes or sedation.
Procedure used to see inside the sigmoid colon and rectum.
Is performed by radiologist, radiologist assistant, or physician assistant. Barium is inserted through a tip in the rectum and fills the colon.
Used to promote defecation.
Functions of the fluid instilled in a cleansing enema.
- Breaks up fecal matter
- Stretches rectal wall
- Initiates defecation reflex
List the types of enemas.
- Tap water (hypotonic)
- Hypertonic solution
- Soapsuds solution
- Oil retention
Enema that should only be done once due to the potential development of water toxicity or circulatory overload.
Tap water (Hypotonic)
Enema typically used when patient cannot tolerate large amounts of fluid. It pulls fluid from the interstitial spaces around the colon. Available commercially under the name Fleet Enema.
Enema that is safest, especially for infants, children, and older patients, because the fluid is of the same osmolarity as the interstitial spaces of the colon.
Enema that promotes peristalsis and defecation but can produce mild irritation of the bowel.
Enema that is absorbed by the stool. Absorption softens stool for easier evacuation.
One of the most important aspect of barium enema examinations is bowel preparation. Most preparations consist of the following:
- Dietary restrictions
- Cleansing water enema
Dietary restrictions are usually in the form of a minimal or low-residue diet. This diet is designed to reduce the frequency and volume of stools while prolonging intestinal transit time. A low-residue diet typically includes restrictions on foods that increase bowel activity such as:
- Milk/milk products
Using a variety of laxatives, including castor oil, bisacodyl, or magnesium citrate to evacuate fecal material from the bowel.
Catharsis; relief of fecal matter affected by a cathartic.
A clear liquid diet is often prescribed for the 24-hr period before a barium examination (Hydration). Clear liquids are easily absorbed by the body and reduce stimulation of the digestive tract. A diet of clear liquids maintains vital body fluids, salts, and minerals. A clear liquid diet includes:
- Carbonated beverages
- Clear gelatin
- Clear broth
- Coffee/tea with sugar
What is the only acceptable contrast media used when perforation of the bowel is suspected?
Water-soluble iodine compound
EXAMPLE: Diatrizoic acid (Gastrografin)
Used to aid in the diagnosis of pathologic conditions that may affect the colon or lower gastrointestinal tract.
Is either single or double contrast.
During a barium enema exam, how far is the bag usually suspended above the table?
up to 30 inches
When will a double-contrast barium enema be used?
- Patients with suspected polyps
- Patients with history of colorectal cancer
- Rectal bleeding
- Anything where colon mucosa needs to be visualized
What is the positive agent in double-contrast barium enemas?
What is the negative agent in double-contrast barium enemas?
- Barium (shows up white)
- Air (shows up black)
Position of patient during a double-contrast barium enema exam.
Prone and in slight Trendelenburg position
Enema in which the colon is filled with barium (no air). Uses larger volume of barium and excess barium is drained back into the bag.
Post evacuation images are taken.
Single-contrast barium enema
Barium enema exams are diminishing because of _________ and __________ examinations.
Barium is naturally __________ and can cause patient dehydration.
Most common complication for colostomy patients.
For colostomy patients, how is contrast administered?
Through a patient stoma
Surgical creation of an opening between the colon and the surface of the body.
Kidney-shaped vessel for the collection of vomitus.
Health professional with special training and certification in the care of ostomies and related concerns.
Usually a nurse.
Gas or air evacuated through the anus.
Radiographic evaluation of the small and large bowel that has been connected to skin surface as a substitute for the urinary bladder with an ostomy.
Cavity/channel within a tube or tubular organ.
Region between thighs, bound in the male by the scrotum and anus. Bound in the female by the vulva and anus.
Physical property if liquids that determines the internal resistance to shear forces.
Subjective sensation or motor phenomenon that precedes and marks the onset of a paroxysmal attack, such as an epileptic attack.
Devices used for application of external electrical shock to restore normal cardiac rhythm and rate.
Automatic External Defibrillators (AEDs)
Condition with sudden onset caused by acute vascular lesions of the brain; often followed by permanent neurological damage.
Cerebrovascular Accident (Stroke or brain attack)
Nosebleed; hemorrhage from the nose.
Seek medical attention if bleeding continues for 15 minutes.
Abnormally increased concentration of glucose in the blood. Develops gradually over a period of hours or days.
Symptoms include excessive thirst/urination, dry mucosa, rapid/deep breathing, drowsiness, and confusion.
Insulin required - leads to diabetic coma if left untreated.
Decreased blood sugar (below normal).
Patients often recognize early signs and need a quick form of carbohydrate/glucose pill.
Symptoms include weakness/shakiness
Condition of profound hemodynamic and metabolic disturbance characterized by failure of the circulatory system to maintain adequate perfusion of vital organs.
Means fainting. A self-correcting, temporary state of shock and the result of lack of blood flow to the brain.
Treatment is aimed at increasing blood flow to the brain.
Considered a mild reaction. It is also called hives.
Disorganized cardiac rhythm.
Illusion of movement; sensation as if the external world were revolving around the patient or as if the patient were revolving in space.
Is often a precursor to syncope.
Separation of the layers of a surgical wound; may be partial, or superficial only, or complete, with disruption of all layers.
List radiology emergencies.
- Pulmonary embolus
- Diabetic reactions
- Cerebrovascular accident (CVA)
- Cardiac/respiratory failure
Most common emergency seen in the radiology department.
May occur within contrast media administration.
Preferred imaging modality for assessment of head injuries.
List the levels of consciousness.
- Unconscious (reacts to painful stimuli)
- Comatose (will not react to any stimuli)
Signs of deteriorating situations.
- Sudden irritability
- Slowing pulse rate
- Slowing respiratory rate
- Change in level of consciousness (LOC)
Responses to deteriorating situations.
- Maintain open airway
- Move patient minimally
- Stop radiographic procedure
- Get medical assistance ASAP
- Monitor patient's vital signs
List the stages of shock.
- Compensatory stage
- Progressive stage
- Irreversible stage
List types of shock.
Shock caused by loss of blood or tissue fluid.
Shock caused by a variety of cardiac disorders, including myocardial infarction.
Shock caused by spinal anesthesia or damage to the upper spinal cord.
Shock caused by sepsis, deep anesthesia, or anaphylaxis.
Signs/symptoms of a patient that might be going into shock include:
- Apprehension/general anxiety
- Decreasing blood pressure
- Cold/clammy skin
How can shock be prevented?
- Maintain normal body temp
- Avoid overheating
- Manage/reduce pain, stress, or anxiety
List of minor medical emergencies.
Commonly called a stroke or brain attack and is more likely to occur in older patients (over 75)
May develop gradually or suddenly.
Loss of consciousness may necessitate CPR.
Patient needs to be placed in recumbent position ASAP.
Unsystematic discharge of neurons of the cerebrum that results in an abrupt alteration in brain function. Accompanied by change in level of consciousness.
Generally a symptom of an underlying condition and begins with little to no warning.