Synonym/Acronym: Rationale Patient Preparation Patients with heart valve disease may be premedicated with antibiotics. Regarding the patient’s risk for bleeding, the patient should be instructed to avoid taking natural products and medications with known anticoagulant, antiplatelet, or thrombolytic properties or to reduce dosage, as ordered, prior to the procedure. Number of days to withhold medication is dependent on the type of anticoagulant. Note the last time and dose of
medication taken. Protocols may vary among facilities. Patients on beta blockers before the surgical procedure should be instructed to take their medication as ordered during the perioperative period. Ensure that this procedure is performed before an upper gastrointestinal (GI) study or barium swallow. Normal Findings
Critical Findings and Potential Interventions Overview (Study type: X-ray, special/contrast; related body system: Digestive system.) Percutaneous transhepatic cholangiography (PTC) is a test used to visualize the biliary system in order to evaluate persistent upper abdominal pain after cholecystectomy and to determine the presence and cause of obstructive jaundice. The liver capsule is punctured with a thin needle under fluoroscopic guidance, and contrast medium is injected as the needle is slowly withdrawn. This study visualizes the biliary ducts without depending on the gallbladder’s concentrating ability. The intrahepatic and extrahepatic biliary ducts, and occasionally the gallbladder, can be visualized to determine possible obstruction. In obstruction of the extrahepatic ducts, a catheter can be placed in the duct to allow external drainage of bile. Endoscopic retrograde cholangiopancreatography (ERCP) and PTC are the only methods available to view the biliary tree in the presence of jaundice. PTC is more invasive and painful to undergo than ERCP.Indications
Interfering FactorsContraindications Patients who are pregnant or suspected of being pregnant when the examination site involves the abdomen, pelvis, or area where the fetus would be in the field of view, unless the potential benefits of a procedure using radiation far outweigh the risk of radiation exposure to the fetus and mother. Patients with conditions associated with adverse reactions to contrast medium (e.g., asthma, food allergies, or allergy to contrast medium). Patients with a known hypersensitivity to the medium may benefit from premedication with corticosteroids and diphenhydramine; the use of nonionic contrast or an alternative noncontrast imaging study, if available, may be considered for patients who have severe asthma or who have experienced moderate to severe reactions to ionic contrast medium. Patients who are chronically dehydrated before the test, especially older adults and patients whose health is already compromised, because of their risk of contrast-induced acute kidney injury. Patients with bleeding disorders or receiving anticoagulant therapy, because the puncture site may not stop bleeding. Patients with cholangitis; the injection of the contrast medium can increase biliary pressure, leading to bacteremia, septicemia, and shock. Factors that may alter the results of the study
Potential Medical Diagnosis: Clinical Significance of ResultsAbnormal Findings In:
Nursing ImplicationsBefore the Study: Planning and ImplementationTeaching the Patient What to Expect
Potential Nursing Actions Make sure a written and informed consent has been signed prior to the procedure and before administering any medications. Safety Considerations
After the Study: Potential Nursing Actions (adsbygoogle = window.adsbygoogle || []).push({});Avoiding Complications
Treatment
Considerations
Followup Evaluation and Desired Outcomes
Cholangiography, Percutaneous Transhepatic is a sample topic from the Davis's Lab & Diagnostic Tests. To view other topics, please log in or purchase a subscription. Nursing Central is an award-winning, complete mobile solution for nurses and students. Look up information on diseases, tests, and procedures; then consult the database with 5,000+ drugs or refer to 65,000+ dictionary terms. Complete Product Information. What are the symptoms of obstructive jaundice?Yellowing of the skin and whites of the eyes, light-coloured stools and dark urine could be signs of obstructive jaundice – a condition where normal drainage of bile from the liver to the small intestines is blocked.
What happens in obstructive jaundice?Obstructive jaundice is a specific type of jaundice, where symptoms develop due to a narrowed or blocked bile duct or pancreatic duct, preventing the normal drainage of bile from the bloodstream into the intestines.
What is the Colour of skin in obstructive jaundice?Jaundice is a yellow color of the skin, mucus membranes, or eyes. The yellow coloring comes from bilirubin, a byproduct of old red blood cells.
Which of the following is elevated in obstructive jaundice?Background: Obstructive jaundice is believed to be characterized by abnormalities of alkaline phosphatase (ALP), rather than aspartate transaminase (AST).
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