post sigmoidoscopy help

[tahnz0]

hi all,

I am a nursing student and I have recieved a assignment question that i am having trouble with. its a multiple choice and a need to show knowlegde and rationales on the answers.

miss bell is 25 years old. is admitted with provisional diagnosis of ulcerative colitis.

qn1. the nurse should instruct pam to assume which of the following positions prior to sigmoidoscopy.

a) left lateral sims

b) right lateral

c) knee-chest

d) prone

this is what im thinking but please someone add their bit of knowledge.

a sigmoidoscopy is a direct visualisation of the sigmid colon and rectum with the use of a sigmoidoscope, looking for polys, CA or other abnormalities.

i believe that the 3 common positions for sigmoidoscopy are

1. prone (jackknife)

2. left lateral (sims)

3. chest knee

i have chosen left lateral (sims) to be the the best answer as its the most comfortable for the patient, it can be aquired on a normal hospital bed and does not require a special expensive table or bed like the Prone position does. it is essential that the buttocks are positioned over the edge of the bed as veiwing of the posterior wall of the upper rectum may require acute angulation of the instrument.

i have read that the knee chest requires a special table as well. and some authors say that the knee chest position may be more comfprtable for the pt than prone but is awkward for the physician

i have completed some placement at an operating theatre and i believe the left lateral position was used in every case that i saw regarding colonoscopy's.

i do however feel that i dont have much of an argument about my answers. if anyone has any ideas.

[WSU_Ally_RN, BSN, RN]

When you post questions like these, it helps to let everyone know what direction you are going in, otherwise it looks like you want us to do your homework for you. So, what do you think it is?? What exactly do you need help with? Have you looked up each of these positions, or even the procedure? A little googling should get you in the right direction.

[Daytonite, BSN, RN]

Hi, tahnz0 and welcome to allnurses! :welcome:

The answer to the question is "A" the left lateral Sims position. The patient has to be positioned this way so the flexible sigmoidoscope can be inserted by the physician and manipulated into the sigmoid colon.

• http://www.gi-associates.com/proc_flex.htm - Flexible Sigmoidoscopy - has an animation of the procedure that you can view
  
• http://www.emedicinehealth.com/sigmoidoscopy/article_em.htm - Sigmoidoscopy - see the link "During the Procedure"
  
• http://www.medicinenet.com/flexible_sigmoidoscopy/article.htm - Flexible Sigmoidoscopy - see the link "What I can expect during flexible sigmoidoscopy"
  
• http://digestive.niddk.nih.gov/ddiseases/pubs/sigmoidoscopy/index.htm - Flexible Sigmoidoscopy

As a new member and a student nurse I would like to let you know that allnurses has a section of forums for nursing students where we have lots of information to help you with your studies. You can get a listing of these forums by clicking on the "Student" tab above. Hope to see you there!

[widi96]

Tahnz0,

I think your post was perfectly acceptable - you stated the question - what you thought was the answer and a complete and thorough rationalization for that answer.

I'm sorry I can't help you much with the answer, as I have very very little GI experience, but I think Daytonite covered it well.

I'm not sure what point WSU was trying to make because everything they tried to argue - you have covered.

Feel free to ask for help in the future - when you show you have done your work and aren't just looking for a free-be (as you have more than shown), we will gladly try to help.

[WSU_Ally_RN, BSN, RN]

Tahnz0,

I think your post was perfectly acceptable - you stated the question - what you thought was the answer and a complete and thorough rationalization for that answer.

I'm sorry I can't help you much with the answer, as I have very very little GI experience, but I think Daytonite covered it well.

I'm not sure what point WSU was trying to make because everything they tried to argue - you have covered.

Feel free to ask for help in the future - when you show you have done your work and aren't just looking for a free-be (as you have more than shown), we will gladly try to help.

The original message was just the question, the answers, and the poster looking for help. I wrote the message I did to see where the person was going, they then edited their message after I posted mine, and then Daytonite answered with her wonderful answer.

[tahnz0]

Hi, tahnz0 and welcome to allnurses! :welcome:

The answer to the question is "A" the left lateral Sims position. The patient has to be positioned this way so the flexible sigmoidoscope can be inserted by the physician and manipulated into the sigmoid colon.

• http://www.gi-associates.com/proc_flex.htm - Flexible Sigmoidoscopy - has an animation of the procedure that you can view
  
• http://www.emedicinehealth.com/sigmoidoscopy/article_em.htm - Sigmoidoscopy - see the link "During the Procedure"
  
• http://www.medicinenet.com/flexible_sigmoidoscopy/article.htm - Flexible Sigmoidoscopy - see the link "What I can expect during flexible sigmoidoscopy"
  
• http://digestive.niddk.nih.gov/ddiseases/pubs/sigmoidoscopy/index.htm - Flexible Sigmoidoscopy

As a new member and a student nurse I would like to let you know that allnurses has a section of forums for nursing students where we have lots of information to help you with your studies. You can get a listing of these forums by clicking on the "Student" tab above. Hope to see you there!

thnkyou very much for the links! i beleive you said the left lateral sims was the correct answer due to the physician being able to manupulate the sigmoioscope into the sigmoid colon. i am unable to find info on the other positions and feel that the only reason the others are not valis is due to cost of special ezuiptment/beds etc, and patient and physican comfort.

pressure area care? does that come in anywhere, or is the patient not under anaesthetic long enough to aquire or have the risk of pressure area complications?

[Daytonite, BSN, RN]

thnkyou very much for the links! i beleive you said the left lateral sims was the correct answer due to the physician being able to manupulate the sigmoioscope into the sigmoid colon. i am unable to find info on the other positions and feel that the only reason the others are not valis is due to cost of special ezuiptment/beds etc, and patient and physican comfort.

pressure area care? does that come in anywhere, or is the patient not under anaesthetic long enough to aquire or have the risk of pressure area complications?

\

i don't even think the other positions are considered unless the patient has some kind of physical problem and can't assume the left lateral sim's position for some reason or another. as far a pressure care, just make sure there are no wrinkles in the sheets under the patient. the procedure takes about 15 to 20 minutes.

i have had a couple of colonoscopies. the doctor who does them does endoscopies exclusively. his clinic is like a turnstile--one patient after the other and it moves along very quickly with people going in and out all day long. i went in june at 9am and was out at 10:30 and this included getting the iv started, having the procedure and recovering. you might check the site of orlive.com to see if they have a video of a colonoscopy which is just a longer version of a sigmoidoscopy so you can watch the procedure. http://www.or-live.com/