Colonoscopy Procedure

Posted By Lhynnelli, RN On September 4, 2010 @ 5:26 am In Medical Laboratory & Diagnostic Test | No Comments

Colonoscopy uses a flexible fiber-optic video endoscope to permit visual examination of the lining of the large intestine. It¶s indicated for patients with history of constipation or diarrhea, persistent rectal bleeding, and lower abdominal pain when the results of proctosigmoidoscopy and a barium enema test are negative or inconclusive. Purpose

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To detect or evaluate inflammatory and ulcerative bowel disease. To locate the origin of lower gastro intestinal bleeding. To aid in the diagnosis of colonic strictures and benign or malignant lesions. To evaluate the colon postoperatively for recurrence of polyps and malignant lesions.

Patient Procedure 1. Check the patient¶s medical history for allergies, medications, and information pertinent to the current complaint. 2. Tell the patient to maintain a clear liquid diet for 24 to 48 hours before the test and to take nothing by mouth after midnight the night before. 3. Instruct the patient regarding the appropriate bowel preparation. 4. Inform the patient that he¶ll receive an I.V. line and I.V. sedation before the procedure. 5. Tell the patient that the colonoscope is well lubricated to ease insertion and initially feels cool. 6. Explain that he may feel an urge to defecate when it¶s inserted and advanced. 7. Inform him that air may be introduced through the colonoscope to distend the intestinal wall and to facilitate viewing the lining and advancing the instrument.

beware that colonoscopy can cause perforation of the large intestine. fulminant granulomatous colitis. and retroperitoneal emphysema. peritonitis. Abdominal palpation or fluoroscopy may be used to help guide the colonoscope through the large intestine. A small amount of air is insufflated to locate the bowel lumen and then advance the scope through the rectum. but not retrieved. 6. 10. or fulminant ulcerative colitis. 4. the stool may contain some blood. 2. The patient is observed closely for signs of bowel perforation. 4. give enema and strain the stools to retrieve it. 11. Baseline vital signs are obtained. 8. For these cases of for screening purposes. Suction may be used to remove blood and secretions that obscure vision. the patient who has had a recent acute myocardial infarction or abdominal surgery. Biopsy forceps or a cytology brush may be passes through the colonoscope to obtain specimens for histologic or cytologic examination. Cover the patient with drape. 6. The physician palpates the mucosa of the anus and rectum and inserts the lubricated colonoscope through the patient¶s anus into the sigmoid colon under direct vision. Precautions 1. 3. 12.[2] Colonoscopy Procedure 1. 7. After polyp removal. Check the patient¶s vital signs and document them accordingly. Continuous or periodic pulse oximetry is advisable. If a polyp is removed. he may resume his usual diet unless the physician orders otherwise. Report excessive bleeding immediately. 9. acute diverticulitis. Watch the patient closely for adverse effects of the sedative. 2. Nursing Interventions for Colonoscopy 1. 5. perforated viscus. a virtual colonoscopy may be an option to help visualize polyps early before they become concerns. This procedure is contraindicated in pregnant woman near term. and one with ischemic bowel disease. 5. 2. Vital signs and electrocardiogram are monitored during the procedure. excessive bleeding. The patient may pass large amounts of flatus after insufflation. 7. 3. an electro-cautery snare may be used to remove polyps. Although it¶s usually a safe procedure. Tissue specimens are immediately placed in a specimen bottle containing 10% formalin and cytology smears in a Coplin jar containing 95% ethyl alcohol. Specimens are sent to the laboratory immediately. . After recovery from the sedation. The patient is assisted onto his left side with knees flexed.

Insufficient bowel preparation or barium retained in the intestine from previous diagnostic studies which makes accurate visual examination impossible. granulomatous or ulcerative colitis. and malignant or benign lesions. or radiation therapy that may hinder passage of the colonoscope. excessive bleeding and retroperitoneal emphysema. the mucosa of the large intestine beyond the sigmoid colon appears light pinkorange and is marked by semilunar folds and deep tubular pits.Interpretations Normal Results y y Normally. Complications y Perforation of the large intestine. . which glistens from mucus secretions. may indicate procrititis. surgery. coupled with histologic and cytologic test results. Blood from acute colonic hemorrhage that hinders visualization. Abnormal Results y Visual examination of the large intestine. Crohn¶s disease. Blood vessels are visible beneath the intestinal mucosa. Interfering Factors y Fixation of the sigmoid colon due to inflammatory bowel disease. Diverticular disease or the site of lower gastrointestinal bleeding can be detected through colonoscopy alone.

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