Endoscopy & EGD

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Study Tools For Endoscopy & EGD

GERD Pathochart (Cheatsheet)
GI Tract Anatomy (Cheatsheet)
Peptic Ulcer Disease Pathochart (Cheatsheet)
Diverticulitis Pathochart (Cheatsheet)
Hiatal Hernia Pathochart (Cheatsheet)
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Outline

Overview

  1. Endoscopy
    1. Camera to view inside body
    2. Diagnose and treat
  2.  EGD
    1. Camera view of upper GI tract
    2. Diagnose and treat

Nursing Points

General

  1. Endoscopy and EGD
    1. Camera through mouth and down esophagus, stomach, small intestines
    2. Look for irregularities
      1. Inflammation
      2. Bleeding/ulcers
      3. Unusual objects
    3. Treat or remove objects as deemed appropriate by gastroenterologist (GI doctor)
  2. Purpose
    1. Find and diagnose cause of symptoms
    2. Treat disease
      1. Remove polyps
      2. Biopsy tissue
      3. Stretch strictures
      4. Peg tube placement
      5. Stop bleed (clip or cauterize)
  3. Indications
    1. Suspected GI bleed
      1. Vomiting blood (or coffee ground emesis)
      2. Black stools
      3. Anemia
    2. Abdominal pain
    3. Difficulty swallowing
    4. Nausea/vomiting
    5. Severe GERD

Assessment

  1. Before
    1. Explain procedure
    2. Signed consent
    3. NPO midnight before

Therapeutic Management

  1. During
    1. IV medication to sedate patient
    2. GI doctor blows air into gut
    3. Vital signs
  2. After
    1. Vital signs
    2. Advance diet as tolerated per doctor order
    3. Assess abdomen (bloating from air should slowly reside)
    4. Monitor stool color for bleeding

Nursing Concepts

  1. Gastrointestinal/Liver Metabolism -> EGD views upper GI tract
  2. Elimination -> bloody or black stools may indicate EGD

Patient Education

  1. Educate patient on results and treatment (after sedation wears off)

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Transcript

Hey guys! Welcome to the lesson on the endoscopy and EGD.

An endoscopy procedure is where a camera is used to look inside the body. An EGD is shown in this picture where the GI doctor places a camera into the patient’s mouth and down their esophagus, stomach, and small intestines to look for irregularities like inflammation, bleeding, or unusual objects. The doctor may treat or remove objects during the EGD. Let’s talk about the purpose of the EGD. 

The purpose of the endoscopy is to diagnose and treat as indicated. Treatment may include removing polyps, taking a biopsy of tissue, or stopping a bleed by clipping or cauterizing. The doctor may stretch strictures that make it hard for patients to swallow or place a peg tube for the delivery of medications or feedings into the stomach if they cannot swallow or eat. This picture shows an ulcer found in the stomach during an EGD procedure. Let’s explore the indications for an EGD procedure. 

An endoscopy or EGD may be indicated if the doctor suspects that the patient may have an upper GI bleed. The doctor might suspect this if they’re vomiting blood, have black stools, or anemia. The procedure may also be done if the patient is having abdominal pain, difficulty swallowing, or nausea and vomiting. Next let’s explore what your role may be before, during and after the procedure. 

So when the procedure is ordered, you will notify the patient and explain to them what to expect during. Have them sign the consent form after they have been notified of any risks. The patient should be NPO the midnight before the procedure so that food matter is not in the way of the camera. 

During the procedure, the patient will be given sedation through the IV and throat numbing spray. The GI doctor will blow air into the gut so they can see inside with the camera. You will be checking vital signs during to make sure the patient remains stable. 

After the procedure, you will monitor the vital signs as the doctor orders them until stable. The doctor will also enter a diet order, such as advance diet as tolerated to general. Assess the patient’s belly to make sure it’s not distended or painful. Keep an eye on their stools for bleeding which usually shows as black when from the upper GI tract. Educate your patient on the results and any treatment that was provided after their sedation wears off. Often the post op nurse will tell them but they won’t remember because of the sedation. 

The priority nursing concepts for the patient with an endoscopy and EGD are gastrointestinal metabolism and elimination. 

Alright guys, let’s review the key points. An endoscopy is where a camera is used to view inside the body. The EGD procedure is where the GI doctor uses a camera to view the upper GI tract. The purpose is to diagnose and treat disease in the upper GI tract. The EGD may be indicated if the doctor suspects a bleed, or if the patient has abdominal pain, nausea, or vomiting. It’s also used for the placement of a peg tube for feedings or medication administration. Before the procedure, explain what will happen and have the patient sign a consent. The patient should be kept NPO midnight before the procedure. During, sedation will be given in the IV and vital signs will be monitored. After it’s over, continue checking vitals and assess the abdomen for distention and pain. Keep an eye on the patient’s stools for changes in color because remember that black stools can indicate an upper GI bleed. 

Okay guys, that’s it on the endoscopy and EGD! Now go out and be your best self today, and as always, happy nursing!

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Concepts Covered:

  • Terminology
  • Respiratory Disorders
  • Emergency Care of the Respiratory Patient
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Noninfectious Respiratory Disorder
  • Musculoskeletal Trauma
  • Oncology Disorders
  • Female Reproductive Disorders
  • Digestive System
  • Upper GI Disorders
  • Lower GI Disorders
  • Gastrointestinal Disorders
  • Pregnancy Risks
  • Renal Disorders
  • Cardiac Disorders
  • Postpartum Care
  • Prenatal Concepts
  • Childhood Growth and Development
  • Cardiovascular Disorders
  • Newborn Complications
  • Postpartum Complications
  • Newborn Care
  • Labor Complications
  • Labor and Delivery
  • Prioritization
  • Test Taking Strategies
  • Integumentary Disorders
  • Legal and Ethical Issues
  • Documentation and Communication
  • Preoperative Nursing
  • Disorders of Pancreas
  • Disorders of the Adrenal Gland
  • Disorders of the Thyroid & Parathyroid Glands
  • Peripheral Nervous System Disorders
  • Liver & Gallbladder Disorders
  • Basics of NCLEX
  • Hematologic Disorders

Study Plan Lessons

Respiratory Terminology
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Acute Respiratory Distress
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Respiratory Infections Module Intro
Respiratory Trauma Module Intro
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Musculoskeletal Assessment
Musculoskeletal Terminology
Complications of Immobility
Reproductive Terminology
Ovarian Cancer
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Cystic Fibrosis (CF)
Genitourinary (GU) Assessment
Gastrointestinal (GI) Course Introduction
Upper Gastrointestinal (GI) Module Intro
Lower Gastrointestinal (GI) Module Intro
Nursing Care Plan (NCP) for Imperforate Anus
Stomach Cancer (Gastric Cancer)
Endoscopy & EGD
Colonoscopy
Nutrition in Pregnancy
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Nutrition (Diet) in Disease
Postpartum Physiological Maternal Changes
Maternal Risk Factors
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Growth & Development – Infants
Congenital Heart Defects (CHD)
Newborn of HIV+ Mother
Postpartum Hemorrhage (PPH)
Initial Care of the Newborn (APGAR)
Dystocia
Postpartum Discomforts
Process of Labor
Infections in Pregnancy
Hydatidiform Mole (Molar pregnancy)
Chorioamnionitis
Gestational Diabetes (GDM)
Antepartum Testing
Oxytocin (Pitocin) Nursing Considerations
Terbutaline (Brethine) Nursing Considerations
Prioritization
Prioritization
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Overview of Childhood Growth & Development
Nursing Care Plan (NCP) for Eczema (Infantile or Childhood) / Atopic Dermatitis
Legal Considerations
Legal Aspects of Documentation
Informed Consent
Metabolic & Endocrine Terminology
Pituitary Adenoma
Pharmacology Terminology
Metabolic/Endocrine Course Introduction
Metabolic & Endocrine Module Intro
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Thyroid Cancer
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Myasthenia Gravis (MG)
Nursing Care Plan (NCP) for Hepatitis
Nursing Care Plan (NCP) for Cushing’s Disease
Critical Thinking
Ventilator Settings
Coagulation Studies (PT, PTT, INR)