Lesson 23. Endoscopy
a. General. Endoscopy is a visual examination of the interior through the use of special instruments called endoscopes. In relation to the digestive system, the term endoscopy is used to describe visual examination of the inside of the GI tract. There are many different types of endoscopes, each designed for a specific use. Generally, the scope consists of a hollow tube with a lighted lens system that permits multi-directional viewing. The scope has a power source and accessories that permit both biopsy and suction.
b. Pre-Procedural Nursing Implications.
- (1) Endoscopic procedures are invasive, and therefore require a formal, signed consent form.
- (2) The patient must be educated about the procedure, the significance of any preparation, and any post-procedural sequelae.
- (3) Upper GI endoscopy (esophagoscopy, gastroscopy) requires that the patient be fasting. Sedatives are administered prior to the procedure to relax the patient and facilitate passage of the scope.
- (4) If the patient wears dentures, have a denture cup available. The physician may require the removal of the dentures prior to oral insertion of the scope.
- (5) Colon endoscopy (proctoscopy, sigmoidoscopy, and colonoscopy) requires that the bowel be free of stool to enhance visualization. This is normally accomplished with laxatives and cleansing enemas.
c. Post-Procedural Nursing Implications.
(1) Accidental perforation of the esophagus or colon may occur during endoscopy. If pain or bleeding occur following the procedure, notify the professional nurse. Note the following:
- (a) Mouth or throat pain.
- (b) Rectal pain.
- (c) Abdominal pain.
- (d) Bleeding from rectum.
- (e) Bleeding from mouth or throat.
- (2) Withhold foods, fluids, and p.o. medications until the patient is fully alert and gag reflex has returned.
- (3) Take vital signs per ward SOP.