3 March 2012

What Is Colonoscopy?and Nursing Intervention

This test is used to diagnose obstruction, bleeding, change in bowel habits, and colon cancer, among other conditions. An informed consent is obtained before the patient is given any type of anesthesia. A colonoscope is passed through the rectum to visualize the anus, sigmoid, descending colon, splenic flexure, transverse colon, hepatic flexure, ascending colon, and the ileo-cecal valve. The colon may be insufflated to aid in visualization of the structures. Biopsies are obtained as indicated. The scope is withdrawn and anesthesia is reversed. The patient may experience abdominal distention. Risks include perforation of the large intestine.The test is commonly performed as an outpatient procedure.
Before the test—A thorough colon prep is necessary to ensure complete emptying of the bowel prior to the procedure. The patient is NPO for several hours prior to the test due to the use of an anesthetic agent.
After the test—Assess the abdomen for bowel sounds and tenderness. Monitor vital signs. Assess the patient for side effects of anesthesia.

Nursing Interventions for Colonoscopy
  • Check the patient’s vital signs and document them accordingly.
  • Watch the patient closely for adverse effects of the sedative.
  • The patient is observed closely for signs of bowel perforation.
  • after recovery from the sedation, he may resume his usual diet unless the physician orders otherwise.
  • The patient may pass large amounts of flatus after insufflation.
  • After polyp removal, the stool may contain some blood. Report excessive bleeding immediately.
  • If a polyp is removed, but not retrieved, give enema and strain the stools to retrieve it.

Da Silva MM, Briars GL, Patrick MK, Cleghorn GJ, Shepherd RW (1997). Colonoscopy preparation in children: safety, efficacy, and tolerance of high- versus low-volume cleansing methods. J Pediatr Gastroenterol Nutr.24(1):33-7.
Decker, Joe (15 November 2006). Preparation: Diet (Blog). Colonoscopy Blog. Retrieved on 2007-06-12.
Dykes C and Cash BD (2008). Key Safety Issues of Bowel Preparations for Colonoscopy and Importance of Adequate Hydration. Gastroenterol Nurs.31(1):30-5; quiz 36-7.