Colonoscopy

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Outline

Overview

  1. Colonoscopy
    1. View inside lower GI tract
    2. Diagnose, biopsy, an/or treat

Nursing Points

General

  1. Procedure
    1. Camera in rectum and colon
    2. Purpose -> Diagnose and treat
      1. Bleed
      2. Polyps
      3. Inflammation
  2. Indication
    1. Abdominal pain
    2. Blood in stool
    3. Diarrhea
    4. Age 50 or older (cancer screening)

Assessment

  1. Before
    1. Explain procedure
    2. Signed consent
    3. Bowel prep (per doctor order)
    4. Hold meds like anticoagulants (per doctor order)

Therapeutic Management

  1. During
    1. IV sedation
    2. Vital signs
  2. After
    1. Vital signs
    2. Explain results and treatment provided (when patient awake and alert)
    3. Advance diet as tolerated (per doctor order)
    4. Assess abdomen for bloating
    5. Monitor stools for bleeding

Nursing Concepts

  1. Gastrointestinal/Liver Metabolism
    1. Camera into lower GI tract
  2. Elimination
    1. Bloody stools/diarrhea indication
    2. Bowel prep

Patient Education

  1. Advance diet as tolerated (no nausea/vomiting)
  2. Resume regular activities
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Transcript

Hey guys! Welcome to the lesson on the colonoscopy!So a colonoscopy is where the GI doctor puts a camera in the rectum and into the colon. It is used to diagnose and treat lower GI tract disorders like bleeding, polyps, and inflammation. Let’s discuss indications for the 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. 

Alright, let’s review the key points. The colonoscopy is where the GI doctor uses a camera to view inside of the lower GI tract. The purpose of the procedure is to diagnose and treat lower intestinal disease. A colonoscopy may be indicated if the patient has ongoing abdominal pain, bloody stools, vomiting, or diarrhea. Before the procedure, explain the risks to the patient and have them sign a consent. The doctor will order a bowel prep for you to give the patient to make them poop all night cleaning out their bowels. The patient will be NPO so that no more food is put into the body. During the procedure, IV sedation will be given and vital signs taken. Vitals will continue after and you will assess the abdomen for pain and distention. Stools should be monitored for bleeding as well. Any problems should be called to the doctor. 

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

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DRN 201, Week 5

Concepts Covered:

  • Oncology Disorders
  • Gastrointestinal Disorders
  • Digestive System
  • Upper GI Disorders
  • Neurologic and Cognitive Disorders
  • Emergency Care of the Trauma Patient
  • Lower GI Disorders
  • Noninfectious Respiratory Disorder
  • Medication Administration
  • Central Nervous System Disorders – Brain
  • Terminology
  • Liver & Gallbladder Disorders

Study Plan Lessons

Colonoscopy
Colorectal Cancer (colon rectal cancer)
Constipation and Encopresis (Incontinence)
Digestion & Absorption
Endoscopy & EGD
Famotidine (Pepcid) Nursing Considerations
Gastritis
Gastrointestinal (GI) Bleed Concept Map
Gastrointestinal (GI) Course Introduction
Gastrointestinal Trauma for Certified Emergency Nursing (CEN)
Lower Gastrointestinal (GI) Module Intro
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) for Aspiration
Nursing Care Plan (NCP) for Bowel Obstruction
Nursing Care Plan (NCP) for Celiac Disease
Nursing Care Plan (NCP) for Colorectal Cancer (Colon Cancer)
Nursing Care Plan (NCP) for Constipation / Encopresis
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed
Nursing Care Plan (NCP) for Imperforate Anus
Nursing Care Plan (NCP) for Peptic Ulcer Disease (PUD)
Nursing Care Plan (NCP) for Stomach Cancer (Gastric Cancer)
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan for Hiatal Hernia
Nursing Case Study for Colon Cancer
Stomach Cancer (Gastric Cancer)
Esophagus
Proton Pump Inhibitors
Pill Crushing & Cutting
Ondansetron (Zofran) Nursing Considerations
Enteral & Parenteral Nutrition (Diet, TPN)
GERD (Gastroesophageal Reflux Disease)
GERD causes Nursing Mnemonic (Reflux Is Probably Mean)
Omeprazole (Prilosec) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Upper Gastrointestinal (GI) Module Intro
Digestive System Anatomy
Digestive Terminology
Histamine 2 Receptor Blockers
NG Tube Medication Administration
NG Tube Med Administration (Nasogastric)
NG (Nasogastric)Tube Management