Colonoscopy

The doctor may order a colonoscopy if the patient has undiagnosed abdominal pain. Keep in mind, the doctor will order other tests first to view inside like and X-ray and maybe a CT scan. If the patient has bloody stools that don’t stop or their hemoglobin is low the doctor may suspect a lower GI bleed and order the colonoscopy to look. Chronic diarrhea or nausea are other indications for a colonoscopy. People that are 50 years or older should have a colonoscopy to check for polyps to rule out cancer. Let’s discuss what to do to prepare the patient for the colonoscopy. 

When the doctor orders a colonoscopy for the patient, you will explain the procedure and risks and get a consent signed. The doctor will order the type of bowel prep that they want the patient to have. Here is a picture of a a type of bowel prep where we fill this container with water and mix it. The patient has to drink this whole thing to help make them poop to clear out their bowels. The doctor will communicate with you any meds that they want you to hold. For example, if they are on anticoagulants the doctor will likely hold them to decrease the chance of a bleed while they go in with the camera. Something good to remember is that the patient needs to have clear liquid mountain dew colored poop by the morning. If it isn’t, the doctor will order enemas to clean them out before the procedure. They have to be cleaned out so that the doctor can see clearly with the camera. If the patient is refusing to drink the prep or is unable, call the GI doctor and let them know because they may order either enemas or an NG tube to push the prep into.

During the procedure, the nurse will give IV sedation to relax the patient. They probably won’t remember the procedure. Vital signs will be taken during the colonoscopy to make sure the patient is stable. Here is a picture of a polyp discovered with the camera during a colonoscopy. 

After the colonoscopy is over, you will monitor vital signs until stable or as the doctor orders them. Explain the results and treatment provided to the patient when they are awake and alert. Advance the patient’s diet as ordered by the doctor. Assess their abdomen for pain and distention, and monitor their stools for blood. 

The priority nursing concepts for the patient with a colonoscopy are gastrointestinal metabolism and elimination.