Which diagnostic test would be used first to evaluate a client with upper GI bleeding?
A. Endoscopy
B. Upper GI series
C. Hemoglobin (Hb) levels and hematocrit (HCT)
D. Arteriography
Correct Answer: A. Endoscopy
Endoscopy permits direct evaluation of the upper GI tract and can detect 90% of bleeding lesions. Endoscopy is the insertion of a long, thin tube directly into the body to observe an internal organ or tissue in detail. It can also be used to carry out other tasks including imaging and minor surgery. Endoscopes are minimally invasive and can be inserted into the openings of the body such as the mouth or anus. An upper GI series, or barium study, usually isn’t the diagnostic method of choice, especially in a client with acute active bleeding who’s vomiting and unstable.
Option B: An upper GI series is also less accurate than endoscopy. Although an upper GI series might confirm the presence of a lesion, it wouldn’t necessarily reveal whether the lesion is bleeding. An upper gastrointestinal series (UGI) is a radiographic (X-ray) examination of the upper gastrointestinal (GI) tract. The esophagus, stomach, and duodenum (first part of the small intestine) are made visible on X-ray film by a liquid suspension. This liquid suspension may be barium or a water-soluble contrast.
Option C: Hb levels and HCT, which indicate loss of blood volume, aren’t always reliable indicators of GI bleeding because a decrease in these values may not be seen for several hours. Upper GI bleeding is sometimes fatal, and the European Society of Gastrointestinal Endoscopy recommends maintaining Hb levels between 7.0–9.0 g/dl using blood transfusion in order to reduce mortality.
Option D: Arteriography is an invasive study associated with life-threatening complications and wouldn’t be used for an initial evaluation. An arteriogram is an imaging test that uses x-rays and a special dye to see inside the arteries. It can be used to view arteries in the heart, brain, kidney, and other parts of the body.
No comments:
Post a Comment