OVERVIEW
Colonoscopy is a technique that uses an optical fiber endoscope to examine and treat the lining of the colon and terminal ileum, and is one of the most commonly used means of diagnosing and treating intestinal diseases. However, the examination has some pain and complications, which are difficult for many patients to accept. Therefore, high-quality nursing measures play an important role in the smooth implementation of colonoscopy, improving the quality of the examination, reducing patient pain and avoiding complications.
Purpose
1. To determine the location and nature of intestinal diseases.
2.To diagnose chronic diarrhea of unknown cause, lower gastrointestinal bleeding, and low intestinal obstruction.
3. To perform colonoscopic treatment, such as colon polypectomy, hemostasis, sigmoid torsion or intussusception reset.
4. Census of colorectal tumors.
use of materials (e.g., fiberoptic endoscopy)
Fiber endoscope.
Operation method
The patient takes the side lying position, the fiber endoscope is inserted through the anus, and the anal canal, rectum, sigmoid colon, colon and ileum are observed from bottom to top in a smooth and clear manner.
Nursing measures
1. Preoperative nursing
(1) Psychological care As colonoscopy is an invasive operation, patients will be more or less fearful and unable to cooperate well with the examination. Nursing staff should be kind and patient, talk with patients, introduce the purpose of the examination, operation methods and precautions in easy-to-understand language, gain patients’ trust, eliminate patients’ nervousness and fear, so as to make them psychologically prepared and actively cooperate with the doctor’s examination.
(2) Physical assessment Comprehensive assessment of the patient’s physical condition, such as age, blood oxygenation, and whether there is a history of heart disease, hypertension, intestinal tumors, etc., whether the coagulation function is normal or not, and whether there is a history of allergy to anesthetics.
(3) Bowel preparation Starting from 3 days before the operation, the patient should be forbidden to have liquid diet or less residue or semi-liquid diet, and the patient should be given laxative to clean the bowel in the evening of the 1st day before the operation or clean enema on the day of the examination, and forbidden to have breakfast on the day of the examination.
(4) Preoperative medication Preoperative medication for colonoscopy is very important to ensure smooth insertion, careful observation and search for lesions, accurate biopsy and fine endoscopic treatment. Preoperative medication also helps to reduce pain and better cooperate with the examination for some nervous patients.
2. Intraoperative care
(1) Assist the patient to take the left side lying position, lower limbs half torso, abdomen relaxation.
(2) Assist the patient to change the position according to the need of the examination, and explain to the patient the possible discomfort during the examination.
(3) Instruct the patient to relax and breathe deeply to reduce abdominal muscle tension and pain.
(4) Observe the patient’s pulse, respiration, oxygen saturation and any bleeding.
(5) Oxygen should be given to patients who are old and have heart disease.
3. Postoperative care
(1) After the examination, use soft tissue paper to help the patient clean the anus and perianal skin.
(2) Monitor the patient’s blood pressure, pulse, respiration, body temperature and other signs, and observe the patient for complications such as abdominal distension, abdominal pain and blood in stool.
(3) Ask the patient to eat non-stimulating and easy-to-digest food after there is no abdominal distension and abdominal pain.
(4) Handle fiberoptic endoscopy in strict accordance with the operation specification to prevent cross-infection.
Health Advocacy
1. Postoperative patients should take proper bed rest.
2. Tell the patient that abdominal distension usually disappears on its own after anal defecation or bowel movement, so there is no need to worry.
3. Slight abdominal pain or discomfort after biopsy is usually relieved by itself.
4. Provide guidance on the patient’s diet, bowel movement and the subsequent treatment measures needed, and inform the patient in writing if necessary.