UPPER/LOWER GI & HEPATOBILIARY DIAGNOSTIC STUDIES – NURS 321 ADULT II
Diagnostic Study
Description & Indications
Nursing Responsibilities
RADIOLOGY (XRAY)
Upper GI or Barium
Diagnose structural abnormalities in PO contrast medium given in advance per
1. 根据机构的协议，提前给予
Swallow
esophagus, stomach, and duodenum institution’s protocol. Explain need to assume
PO 造影剂。
(e.g. hiatal hernia)
multiple position on x-ray table. NPO 8-12
hrs before (or per protocol). Avoid smoking 2. 解释需要在 X 射线台上采取
before study. After procedure provide
诊断食道、胃和十二指肠的结构
多种姿势。
fluids/laxatives as ordered to prevent
异常（如食道裂孔疝）。.
impaction from contrast medium (barium).
3. 8-12 小时前（或根据协议）
Assess for signs/symptoms of impaction.
进行 NPO。
Expect white stools x 72 hours.
4. 研究前避免吸烟。
5. 手术后按医嘱提供液体/缓和
剂，以防止造影剂（钡）的
嵌塞。
6. 评估有无嵌塞的迹象/症状。
7. 预计 72 小时后会有白色大
便。
Lower GI or Barium
Enema
Structural examination of the colon
Prep bowel with laxatives/enemas evening
before (per protocol) until colon clear of
stool. Clear liquid diet evening before study.
NPO 8 hrs before study. Explain to client
about cramping & urge to defecate during
procedure (same feeling as regular enema).
Explain need to assume multiple positions on
x-ray table. After procedure provide
fluids/laxatives/suppositories as ordered to
clear colon of barium.
1. 前一天晚上用泻药/酶制剂准
备肠道（根据协议），直到
结肠内无大便。
2. 研究前一天晚上吃清流食。
3. 研究前 8 小时内不服用药
物。
4. 向客户解释手术过程中的痉
挛和排便冲动（与普通灌肠
的感觉相同）。
UPPER/LOWER GI & HEPATOBILIARY DIAGNOSTIC STUDIES – NURS 321 ADULT II
5. 解释需要在 X 射线台上采取
多种姿势。
6. 手术后，按医嘱提供液体/缓
和剂/栓剂以清除结肠中的钡
剂。
ULTRASOUND
Ultrasound abdominal,
hepatobiliary,
gallbladder)
Detect abdominal masses. Detect
liver tumors, cirrhosis, visualize
biliary ducts. Detect gallstones.
NPO 8-12 hours before (if possible).
NPO 8-12 hours before (if
possible).
检测腹部肿块。检测肝脏肿瘤、
RADIOLOGY
COMPUTED
TOMOGRAPHY (CT
SCAN) abdomen/pelvis
肝硬化，观察胆管。检测胆结石
Used to diagnose abnormalities to
multiple organs/structures in
abdomen and pelvis. Contrast
medium given to accentuate density
differences.
用于诊断腹部和盆腔的多个器官/
结构的异常。给予对比剂以突出
Depending upon reason for scan, institution
1. 根据扫描的原因、机构协议
protocol, and individual client’s history, PO
和个人客户的历史，将给予
and/or IV contrast medium will be given.
Screen clients for history of allergies to
PO 和/或 IV 造影剂。
contrast medium. Determine is client has
2. 筛选客户对造影剂的过敏
sensitivity to iodine (although this may
depend upon the contrast medium used by the
史。
institution – always check institution’s
3. 确定客户是否对碘敏感（但
policies).
这可能取决于机构使用的造
密度差异。
影剂--一定要检查机构的政
策）。
MAGNETIC
RESONANCE
IMAGING
(MRI)
Stage colorectal cancer. Identify
sources of bleeding. Detect hepatic
metastases.
对结直肠癌进行分期。识别出血
Contraindicated for clients with any metal
implants. MRI safety screening must be
completed before study. Client may
experience claustrophobia. Clients often are
given a benzodiazepine before study.
1. 禁忌：有任何金属植入物的
客户。
2. 研究前必须完成 MRI 安全检
UPPER/LOWER GI & HEPATOBILIARY DIAGNOSTIC STUDIES – NURS 321 ADULT II
源。检测肝脏转移。
查。
3. 客户可能会出现幽闭恐惧
症。
4. 研究前通常会给病人服用
benzodiazepine 药物。
ENDOSCOPY
Esophagogastroduodeno
scopy (EGD)
Directly visualize the mucosal lining
of the esophagus, stomach and,
duodenum. Can be used to identify
source of upper GI bleeding and
treat bleeding directly at site.
直接观察食管、胃和十二指肠的
粘膜。可用于确定上消化道出血
Signed consent before procedure. NPO for 8
hours before procedure (or per protocol).
Explain that client will be sedated for
procedure. Topical anesthetic is usually
sprayed at back of throat. After procedure
keep NPO until gag reflex returns. Can use
salt water gargles for sore throat. Monitor VS
including temperature carefully after
procedure. Fever is sign of perforation.
1. 手术前已签署同意书。
2. 在手术前 8 小时内 NPO（或根据
协议）。
3. 解释客户将在手术中使用镇静
剂。
4. 局部麻醉剂通常喷洒在喉咙后
面。
5. 手术后保持 NPO 状态，直到咽喉
的来源并直接治疗出血部位。
反射恢复。
6. 可使用盐水漱口治疗咽喉肿痛。
7. 手术后要仔细监测 VS，包括体
温。发烧是穿孔的标志。
Colonoscopy
Directly visualize colon from anus
to ileocecal valve. Used to diagnose
tumors, IBD, diverticulosis. Can be
Signed consent before procedure. Bowel
preparation required, type depends upon
physician. Clear liquid diet 1-2 days before.
1. 在手术前签署了同意书。
2. 需要进行肠道准备，类型取决于
UPPER/LOWER GI & HEPATOBILIARY DIAGNOSTIC STUDIES – NURS 321 ADULT II
used to dilate strictures and
NPO for 8 hours before (or per protocol)
医生。
remove/biopsy polyps. Gold
Cathartic and/or enema may be given the
3. 前 1-2 天吃清淡的流食。
standard screening for colon cancer. night before study. Sedation is provided and
procedure done in a side-lying position. May 4. 实验前 8 小时内不吃药（或根据
协议），
直接观察从肛门到回盲瓣的结肠。用 experience cramping and flatus after
procedure. Monitor VS and assess for signs of
5. 研究前一天晚上可使用阴离子和/
于诊断肿瘤、IBD、憩室病。可用于 lower GI bleeding after procedure.
或灌肠剂。
扩张狭窄处和切除/活检息肉。结肠
6. 提供镇静剂，手术以侧卧姿势进
癌筛查的金标准。
行。
7. 手术后可能会出现痉挛和排便。
8. 术后监测 VS 并评估下消化道出
血的迹象。
Endoscopic retrograde
cholangiopancreatograp
hy (ERCP)
Endoscope inserted through oral
cavity and into duodenum. Common
bile and pancreatic ducts are
cannulated and contrast media is
injected to visualize structures. Can
be used to remove gallstones, obtain
biopsy, dilate strictures, and
diagnose pseudocysts.
Same as EGD. Pancreatitis is most common
complication. Assess for signs/symptoms of
pancreatitis after procedure.
与 EGD 相同。
胰腺炎是最常见的并发症。手
术后评估胰腺炎的体征/症状。
内窥镜通过口腔插入十二指肠。总胆管和胰腺管
被插管，注射造影剂以观察结构。可用于清除胆
结石，获得活检，扩张狭窄处，以及诊断假性囊
肿。
LIVER BIOPSY
Needle is inserted through
intercostal space on right side to
obtain a specimen of liver tissue.
Often done with CT or ultrasound
guidance
Signed consent before procedure. Check
client’s coagulation values. Ensure client has
been typed and cross-matched. After
procedure position client on right side for
minimum of 2 hours to splint puncture site.
Keep in bed flat for 12 hours. Assess for signs
of peritonitis, shock, pneumothorax.
1. 手术前签署同意书。
2. 检查客户的凝血值。
3. 确保客户已被分型和交叉配
型。
4. 手术后将病人置于右侧，至
少 2 小时，以夹住穿刺部
位。
UPPER/LOWER GI & HEPATOBILIARY DIAGNOSTIC STUDIES – NURS 321 ADULT II
5. 保持平卧 12 小时。
6. 评估是否有腹膜炎、休克、
气胸的迹象。
Also review fecal analysis, and stool culture