GI case study help

hi, lfinny!

the test reference that i have makes these suggestions for the nursing care after the colonoscopy. i am paraphrasing:

• inform the patient that they may experience gas pain or flatulence. it is because during the procedure the doctor pumped some air into the bowel to be able to visualize the inner anatomy better.
  
• perform a thorough abdominal exam. make particular note of any abdominal distention and tenderness which may be possible evidence of colon perforation.
  
• take vital signs at regular intervals.
  
• monitor for signs of hemorrhage (decrease in b/p, elevated pulse)
  
• check any stools for gross blood
  
• if the patient should complain of any increased pain or evidence of bleeding, notify the doctor immediately
  
• when satisfied that no symptoms of bowel perforation exist, offer food.
  
• encourage fluids and instruct patient to drink plenty of fluids to replace water losses from the bowel prep.

discharge instructions to the patient should include:

• instructing the patient to notify the doctor or clinic if they have any increasing abdominal pain
  
• that if biopsies were done or polyps removed, the patient's first stools may contain some gross blood
  
• instructing the patient that passing gas after this procedure is normal, but if he/she starts to develop abdominal bloating they should notify the doctor or clinic immediately
  
• if fever and chills develop (symptoms of perforation), call the doctor immediately.

my doctor had me call back in a week for the biopsy results.

i pulled the discharge instructions my mother got when she had her colonoscopy 4 months ago. and this is what they say (paraphrased):

• call the doctor's office in 2 weeks for results (she had polyps removed).
  
• some drops of blood might be noted on your underwear, or on the toilet paper after you go to the bathroom. this is because of irritation to the bowel during the colonoscopy. if you have heavier bleeding or the bleeding continues for three or more days after the colonoscopy, call our office.
  
• you may feel cramps or gassy for a few hours. this is because air was introduced into your colon. you should start to expel this gas before you leave our clinic today. if you have any stomach pain or notice any swelling, call our office right away.
  
• you may have some nausea today. this is because of the medications we used. it should get better in a few hours. if you are still having nausea after 24 hours, call our office.
  
• you may start taking small sips of water and as you feel better progress to solid foods.
  
• do not drive or operate any dangerous equipment. medications you were given today will cause you to be weak, lack coordination and even continue to feel drowsy.
  
• you should not sign any legal documents or conduct any important business today because of the medications you were given today.
  
• if you develop any redness or swelling at the sites where medications were given to you today (mom had im injections), put a warm, wet washcloth over these areas for 20 minutes. if they do not improve after 2 days, call our office.
  
• if you develop a fever of 101 or higher, or chills, during the next 48 hours, call our office.
  
• please do not strain when you move your bowels.
  
• call our office for any questions or if any problems arise.

hope you find that helpful. welcome to allnurses! :welcome: