A female client being seen in a physician’s office has just been scheduled for a barium swallow the next day. The nurse writes down which instruction for the client to follow before the test?
A. Fast for 8 hours before the test
B. Eat a regular supper and breakfast
C. Continue to take all oral medications as scheduled
D. Monitor own bowel movement pattern for constipation
Correct Answer: A. Fast for 8 hours before the test.
A barium swallow is an x-ray study that uses a substance called barium for contrast to highlight abnormalities in the gastrointestinal tract. The client should fast for 8 to 12 hours before the test, depending on physician instructions. The barium swallow study, also known as a barium esophagogram or esophagram, is a contrast-enhanced radiographic study commonly used to assess structural characteristics of the entire esophagus.
Option B: Patients must be capable of swallowing relatively large amounts of contrast without assistance and be able to protect their airways. For visual studies focusing on the pharynx and esophagus, minimal preparation is required. However, patients should be able to tolerate swallowing liquids.
Option C: Most oral medications also are withheld before the test. Oral barium contrast has relatively few adverse effects in standard practice. Most commonly, patients complain of nausea and vomiting within 30 minutes of ingestion. Hypersensitivity reactions have been reported but are uncommon. Most adverse effects are related to the extravasation of contrast into the mediastinum or from aspiration.
Option D: After the procedure, the nurse must monitor for constipation, which can occur as a result of the presence of barium in the gastrointestinal tract. The barium esophagogram is noninvasive and readily performed, requiring only radiographic still-image capability and contrast medium. As such, it is a useful exam despite the current wide availability of CT imaging.
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