A client is scheduled for a colonoscopy this morning and the nurse notes the client is continuing to have stool

in the last output after the prescribed phospho-soda enema. The appropriate action for the nurse to take is to:: Notify the provider *stool will impede visualization. Additional interventions may be necessary, including delay or cancellation of the procedure A client is scheduled for a colonoscopy. The provider has ordered a bowel prep using polyethylene glycol (GoLYTELY). The nurse should include which of the following in the instructions to the client?: Medication taken with this prep will not be absorbed *The client should be NPO for at least 4 hr prior to beginning the bowel prep. The client will need to consume the full prescribed amount of polyethylene glycol. Its effects should be observed within 1 hr. Motility will be increased with the effects of the polyethylene glycol, which would greatly reduce the likelihood of medication absorption. A client is scheduled for both an upper gastrointestinal and barium enema. How should the nurse schedule these exams?: The barium enema should be scheduled the same day but before the upper gastrointestinal *The barium enema can be done on the same day as the upper gastrointestinal, but it needs to be done first to avoid barium entering the colon from the upper intestinal track. Both procedures are done with the client NPO. After a scope procedure a client is difficult to arouse. The priority action for the nurse to perform at this time is to:: assess the client's airway *Following the airway, breathing and circulation (ABC) priority framework, the priority intervention is airway maintenance. The other interventions are important, but not the priority. other options included: allow the cleint to sleep, increase rate of IV fluids, evaluate preprocedure laboratory tests for abnormalities Alanine aminotransferase (ALT): Normal Values: 8 to 20 units/L 3 to 35 IU/L Interpret. of findings: Elevation occurs with hepatitis or cirrhosis Albumin: Normal Values: 3.5 to 5.0 g/dL Interpret of findings: Decrease may indicate hepatic disease Alkaline phosphatase (ALP): Normal Values: 42 to 128 units/L 30 to 85 IU/L Interpret of findings: Elevation indicates liver damage Alpha-fetoprotein: Normal Values: <40 mcg/L Interpret of findings: Elevated in liver cancer Ammonia: Normal Values: 15 to 110 mg/dL Interpret of findings: Elevated in liver disease Amylase: Normal Values: 56 to 90 IU/L Interpret of findings: Elevation occurs with pancreatitis Aspartate aminotransferase (AST): Normal Values: 5 to 40 units/L Interpret. of findings: Elevation occurs with hepatitis or cirrhosis Colonoscopy- involves the use of a flexible fiberoptic colonoscope to visualize the colon. After entering through the anus, the rectum, sigmoid, descending, transverse, and ascending colon can be visualized: ANESTHESIA: moderate sedation- midazolam (Versed) usually given w/ an

such as bisocodyl [Dulcolax] and polyethylene glycol [GoLYTELY].similar to colonoscopy. alanine aminotransferase (ALT). rectum. notify provider of bleeding. Allows visualization of the biliary ducts and gall bladder: ANESTHESIA: Conscious sedation . and duodem. status. bile duct obstruction. bilirubin. instruct client that there may be increased flatulence due to air instillation during procedure Direct (conjugated) bilirubin: Normal Values: 0 to 0. thus allowing visualization of only the anus.0 mg/dL Interpret of findings: Elevation indicates altered liver functioning. Allows visualization of these structures: ANESTHESIA: moderate sedation. and sigmoid colon: ANESTHESIA: None required POSITION: On left side PREPARATION: Bowel prep (Dulcolax. status. or other hepatobiliary disorder EGD-involves insertion of an endoscope through the client's mouth and esophagus. NPO after midnight). withhold fluids until return of gag reflex ERCP. remove dentures prior to procedure.0 mg/dL Interpret of findings: Elevations indicate altered liver functioning. or other hepatobiliary disorder . and albumin Other blood tests that provide information on the functioning of the GI system include:: Amylase. or othe hepatobiliary disorder Lipase: Normal Values: 0 to 110 units/L Interpret of findings: Elevation occurs with pancreatitis Liver function tests: Aspartate aminotransferase (AST). notify provider of bleeding. instruct client to avoid meds per provider POSTPROCEDURE: monitor for rectal bleeding. and any evidence of infection. monital VS and resp. status. NPO after midnight.3 mg/dL Interpret of findings: Elevations indicate altered liver functioning.topical anesthetic POSITION: initially semi-prone with repositioning throughout procedure PREP: NPO 6 to 8 hr. stomach. resume normal diet if ordered. and any evidence of infection.1 to 1. bile duct obstruction. bile duct obstruction. and ammonia Sigmoidoscopy.opiate analgesic POSITION: Left side with knees to chest PREP: bowel prep (may include laxatives. instruct the client to avoid meds per the provider's order POSTPROCEDURE: monitor for rectal bleeding. resume normal diet if prescribed. but scope is shorter.topical anesthetic POSITION: left side-lying PREP: NPO 6 to 8 hr. status. abdominal or chest pain. abdominal or chest pain. remove dentures prior to procedure POSTPROCEDURE: monitor vital signs and resp. instruct client of increased flatulence Total bilirubin: Normal Values: 0 to 1. alkaline phosphatase (ALP). monitor vital signs and resp. encourage plenty of fluids. alpha-fetoprotein. withhold fluids until the client's gag reflex returns Indirect (unconjugated) bilirubin: Normal Values: 0. explain procedure and need to change positions during procedure POSTPROCEDURE: monitor VS and resp. encourage plenty of fluids. lipase. clear liquid diet.involves insertion of an endoscope through the client's mouth and into the viliary tree via the duodenum. GoLYTELY). clear liquid diet.

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