NCLEX Review Guide: Gastrointestinal & Nutrition Diagnostic Procedures

Upper Endoscopy (EGD)

• Esophagogastroduodenoscopy (EGD) allows direct visualization of the upper GI tract from esophagus to duodenum. NPO 8-12 hours before procedure to prevent aspiration during sedation.
• Post-procedure monitoring includes gag reflex assessment before oral intake and observation for bleeding, perforation, or respiratory distress. Patient remains NPO until gag reflex returns completely.

Upper GI Series (Barium Swallow)

• Patient drinks barium sulfate contrast while X-rays track its movement through the upper GI tract. Identifies structural abnormalities, ulcers, and motility disorders.
• Post-procedure care includes increased fluid intake and monitoring for constipation as barium can cause impaction if not eliminated properly.

Colonoscopy

1. Pre-procedure: Clear liquid diet 24 hours before and bowel preparation with laxatives/enemas
2. During: Direct visualization of entire colon with flexible scope under conscious sedation
3. Post-procedure: Monitor vital signs, assess for bleeding/perforation, resume diet gradually

Sigmoidoscopy

• Examines lower 25cm of colon using flexible or rigid scope. Less extensive prep required than colonoscopy - typically enemas only.
• Post-procedure monitoring focuses on abdominal pain assessment and watching for signs of perforation including severe pain, distension, or fever.

Liver Biopsy

• Percutaneous needle biopsy obtains liver tissue for histological examination. Check coagulation studies (PT/INR, PTT) before procedure due to bleeding risk.
• Post-biopsy positioning: Right side-lying for 2-4 hours to apply pressure to puncture site and prevent bleeding into peritoneal cavity.

Paracentesis

• Removal of ascitic fluid from peritoneal cavity for diagnostic analysis or therapeutic relief. Measure abdominal girth before and after procedure.
• Monitor for hypotension and electrolyte imbalances especially if large volume removed, as fluid shifts can cause circulatory compromise.