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Introduction ⬇

Abdominal radiography, or abdominal x-ray, does not use contrast media. It is performed to aid in the diagnosis of intra-abdominal diseases such as nephrolithiasis, intestinal obstruction, soft tissue mass, or ruptured viscus. A KUB may be performed to detect problems in the GU system. A scout film is a preliminary x-ray that is performed to evaluate the GI tract, the gallbladder, or the urinary tract, and it is done before a more definitive imaging study is ordered. An acute abdominal series is a set of images that are obtained of the abdomen to evaluate the patient for bowel obstruction or functional intestinal paralysis. Abdominal images also provide information on the size, shape, and position of the liver, spleen, and kidneys.

Procedure ⬆ ⬇

  1. Have the patient wear a hospital gown. Tell the patient to remove all metallic objects from the abdominal area.

  2. Have the patient lie in a supine position on the x-ray table.

  3. Obtain multiple images (including upright or left decubitus) for an abdominal series to assess air–fluid levels.

  4. Follow guidelines in Chapter 1 for safe, effective, informed intratest care.

Clinical Implications ⬆ ⬇

Abnormal abdominal x-ray results may reveal the following conditions:

  1. Calcium deposits in blood vessels and lymph nodes; cysts, tumors, or stones

  2. Calculi within the ureters, although ureters are not clearly defined

  3. Abnormal kidney size, shape (such as horseshoe-shaped kidneys), and position

  4. Appendicolithiasis

  5. Foreign bodies

  6. Abnormal fluid; ascites

  7. Large tumors and masses (e.g., bladder, ovarian, or uterine), if they displace normal bowel configurations

  8. Abnormal gas distribution associated with bowel perforation or obstruction

  9. Fusion anomalies

Interventions ⬆ ⬇

Pretest Patient Care

  1. Explain the purpose and procedure of the test. Tell the patient that a normal diet is allowed unless contraindicated. Assure the patient that the procedure in itself is not painful.

  2. Ask the patient to remove belts, zippers, jewelry, and other ornamentation from the abdominal area.

  3. Instruct the patient to remain still and to follow breathing instructions.

  4. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Clinical Alert

  1. Abdominal plain x-rays are not diagnostic for certain conditions, such as esophageal varices or bleeding peptic ulcer.

  2. A portable x-ray machine may be used in the nursing unit if the patient cannot be moved. Assist with patient positioning as necessary. The x-ray technologist is responsible for clearing all unnecessary personnel from the radiation field before the x-ray is taken.

Posttest Patient Care

  1. Review test results; report and record findings. Modify the nursing care plan as needed. Monitor for intra-abdominal disease.

  2. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.

Interfering Factors ⬆ ⬇

  1. Barium may interfere with optimal visualization. Therefore, this examination should be done before barium studies.

  2. The supine position of the abdomen does not detect free air.

Reference Values ⬆

Normal

Normal abdominal structures