COLONOSCOPY

DEFINATION
Colonoscopy is a procedure used to see inside the colon and rectum. Colonoscopy can detect inflamed tissue, ulcers, and abnormal growths. The procedure is used to look for early signs of colorectal cancer and can help doctors diagnose unexplained changes in bowel habits, abdominal pain, bleeding from the anus, and weight loss.

INDICATION
1.

2. 3.

Evaluation of active or occult lower GI bleeding e.g:hematochezia,melena,unexplaine d occult blood. Suspected caecal or ascending colonic disease. Previous colon CA

4. Diagnostic or management of chronic inflammatory bowel disease. 5. Altered bowel habits

PREPARATION
1)PRE-PROCEDURE Prior to procedure the pt must undergo bowel cleansing. The nurse should be sure the patient has written instructions on the use of bowel cleansing technique. The patient should refrain from using iron supplement and aspirin or anticoagulation 1week prior procedure

PERSEDIAAN UNTUK FLEET

HARI 2 HARI SEBELUM KOLONOSKOPI

MASA

CARA MEMAKAN Jangan makan sayur, daging,ayam, ikan, agaragar(jelley).

SARAPAN PAGI

Makan roti putih, mee kosong

12 TENGAHARI

Makan bubur kosong

SATU HARI SEBELUM KOLONOSKOPI

1 tengahari

Tidak boleh makan sehingga prosedur, minum dibenarkan

2 petang

Makan ubat fleet 45ml.minum banyak air kosong tanpa susu. Sekurang- kurangnya 6 gelas, Cuma minum air jernih ( 100 plus, glukos -yang warna putih)

8 malam

Makan ubat fleet 45ml.minum banyak air kosong tanpa susu. Sekurang- kurangnya 6 gelas, Cuma minum air jernih ( 100 plus, glukos -yang warna putih)

12 malam

puasa (tidak boleh minum/makan)

PERSEDIAAN UNTUK FORTRAN

HARI 2 HARI SEBELUM KOLONOSKOPI

MASA

CARA MEMAKAN Jangan makan sayur, daging,ayam, ikan, agaragar(jelley).

SARAPAN PAGI

Makan roti putih, mee kosong

12 TENGAHARI

Makan bubur kosong

SATU HARI SEBELUM KOLONOSKOPI

1 tengahari

Tidak boleh makan sehingga prosedur, minum dibenarkan

5ptg 6ptg 6ptg 7mlm 7mlm 8 mlm

12mlm

Minum 1 paket fortran yang telah dicampur dengan 1 liter ai

puasa

ENDOSCOPY(PREPROCEDURE)

Admission- check pt details ; name Observation- document baseline B/P,pulse,resp,SPO2, councious and pain level. Fasting 6-8 hrs Ask patient regarding their bowel prep output Medication- allergies and dly medications The physician should obtain an informed consent from the pt or responsible adult. Blood investigation- if required

Medical and surgical history Remove all jewellery- metal Remove all prothesis; dentures,contact lenses Insertion of i/v line Patient should be given opportunity to urinate before procedure- more comfortable Preparation of equipments/acessories

2) INTRA-PROCEDURE Patient positioning: left lateral Monitor vital sign-SPO2 Level of consciousness-vagal respone,and pain tolerance Oxygen via nasal cannula at 2L may be administered when using IV moderate sedation

Notified to DR if the abdomen becomes excessively distended because of air insufflation Instructions in breathing technique-may be offered to help the pt cooperate more readily If there is specimens- labelled,bagged and sent to laboratory

3)POST-PROCEDURE Pt should be kept on side till fully awake and able to control secretion Monitor vital sign every 15 min until return to baseline unless condition warrants more frequent monitor If patients undergo polypectomy/biopsy-observed for bleeding, abdo distention and rigidity. If necessary-admit for observation Cleaning and disinfectant of equipments/acesssory

DISCHARGE PLAN
Give follow up appoinment as directed by physician Health education; diet,bleeding, bloating and medication. Advisable to accompany by relative

Contraindication
Acute or recent myocardial infarction. Toxic, fulminant colitis. Perforation of abdominal viscose. Severe coagulopathy. Acute diverticulitis

Complication
Bleeding Perforation Adverse reactions to sedation include Vasovagal attack

FINDING