SIGMOIDOSCOPY – Definition, Purpose, Principle, General Instruction, Preliminary Assessment, Preparation of the Article, Preparation of the Patient, Procedure and After Care
DEFINITION
Sigmoidoscopy is defined as an examination of the distal sigmoid colon, rectum and anal canal
PURPOSE
- To diagnose malignant and benign neoplasm
- To detect hemorrhoids, polyps, fissures and fistula
- To detect abscesses within the anal canal and rectum
- Before the rectal surgery
- To evaluate rectal bleeding, acute or chronic diarrhea
PRINCIPLE
- Microorganism are found everywhere the nurse takes care to prevent the transference of microorganism
- A thorough knowledge about the anatomy and physiology of the GI tract
- Mental and physical preparation of the patient facilitates introduction of the tube
- Systematic ways of functioning may save time, energy, and material
- Any unfamiliar situation produces fear and anxiety
GENERAL INSTRUCTION
- Explain the procedure to the client and win his confidence and cooperation
- The client assumes a knee-chest position
- The client is instructed to eat a light evening meal prior to the examination
- The nurse should remain with client. Watch his general condition and monitor the vital signs and skin color
- Both doctor and nurse should follow strict aseptic technique
- Lubricate the instrument before introducing into the rectum
- Do not expose the patient unnecessarily
PRELIMINARY ASSESSMENT
- Identify the patient name, age, ward, bed number, sex and diagnosis
- Check doctors order for specific precautions
- Check the general condition of the patient
- Check for any lesions on the rectal area
- Check the consciousness and ability to follow instruction
- Assess the need for extra help
- Articles available in the unit
PREPARATION OF THE ARTICLE
- Sigmoidoscope
- Draping sheet
- Gloves
- Lubricant
- Cotton swabs
- Emesis basin
- Toilet tissue
- Biopsy forceps
- Suction machine
- Paper bag
PREPARATION OF THE PATIENT
- Explain the procedure to the client
- Provide privacy with curtains and adequate draping
- Cover the patient with sheet or bath blanket
- Remove the back rest and extra-pillows
- Place the mackintosh and towel under the patient
- Place the patient in a knee-chest position
- Keep all the article arranged on the bedside locker and check the article for good working condition
- Remove the bottom garments or raise it up above the waist level
- Fold back a small portion of the sheet or bath blanked to expose only the anal region
PROCEDURE
The client assumes a knee chest position and encourages him to relax, as much as possible and to take deep breathing. The physician usually first examines the rectum with gloved fingers. After that the sigmoidoscope is inserted into the anus to visualize the distal sigmoid colon and rectum. A flexible sigmoidoscope is also make it possible to visualize the descending colon and rectum. The examines may obtain specimen from suspicious looking access of anus
AFTER CARE
- The client is observed for signs of peforation, such as bleeding, liver, etc
- Label and send the specimen to the laboratory
- Allow the patient to take rest
- Replace all the articles
- Recording and reporting (time, data, patient responses to the procedure complication if any)
