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01.14 Colonoscopy

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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

Reference Links

Study Tools

Video 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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