Diagnostic studies & assessments

• Subjective assessment

  • appetite
  • abdominal pain
  • bowel and nutrition habits
  • nausea and vomiting
  • swallowing
  • food intolerance or allergy
  • meds
  • past history
• Objective assessment

  • inspection: mouth, abdomen, anus
  • auscultation
  • percussion
  • palpation
• Assessment abnormalities

  • candidiasis: white curdlike lesion
  • dysphagia: difficulty swallowing
  • eructation: burping
• Assessment abnormalities

  • hematemesis: vomiting blood
  • pyrosis: burning in epigastric, heartburn
  • dyspepsia: burning or indigestion
  • nausea/vomiting: feeling of impending vomiting/expulsion of gastric content
• Assessment abnormalities:

  • borborygmi: gurgling abdominal sounds
  • hernia: bulge in abdomen
  • melena: black tarry stool (digested blood)
  • hemorrhoids: thrombosed vein in rectum/anus
• Nausea and vomiting is the most common manifestation of GI disease although it could be unrelated (eg: pregnancy)
• Upper GI series/barrium swallow: visualisation of esophagus, stomach and small intestine by means of fluoroscopy and radiography exam
• Barium swallow

  • maintain NPO 8-12 hours before procedure
  • ingestion of 8-16 oz required
  • post procedure: give plenty of fluid and warn that stool can be whit up to 72 hours
• Lower GI series/barium enema: observe by the means of fluoroscopy the filing of the colon with contrast medium and observe by radiograph the filled colon
• Barium enema:

  • administration of laxatives until colon is clear
  • clear fluid diet night before and NPO 8h before test
  • administer barium enema through rectum
  • possible cramping or urge to defecate
  • post procedure: administer fluids, administer laxative, chalky and white stool for 72 hours
• Abdominal ultrasonography

  • non radiographic study used to show size and configuration of organs
  • can detect abdominal masses, biliary and liver disease, gallstones
  • NPO 8-12 hours before test
• Endoscopy/gastroscopy: visualisation of esophagus, stomach and duodenum with a flexible endoscope
• Gastroscopy

  • NPO 8h before procedure
  • signed consent
  • administer local anesthesia and conscious sedation via IV
  • monitor VS, O2 administration PRN
  • post procedure: keep NPO until gag reflex comes back, monitor VS, may experience throat discomfort for a few days
• CT scan

  • non invasive radiological at different depth
  • may be used with contrast (oral or IV)
• MRI

  • non invasive using radiofrequency waves and magnetic field
  • may use IV contrast medium
• Virtual colonoscopy

  • combination of CT scans and MRI with virtual reality software
  • air introduced in rectum to enlarge colon and enhance visualization