The clinical day at the endoscopy of the Yavapai Regional Hospital was incredibly insightful and educational. The nurses were inviting and encouraged the students to generate any clarifying questions. They also strived for the students to administer as much intravenous catheterization as possible. The endoscopy unit performed several different diagnostic studies that concerned the entire intestinal tract. All of the patients who had some type of procedure performed were sedated with anesthesia and fall precautions were implemented once given. In this unit, there were three sets of nurses who all had different roles in management patient care, teaching and preparation.
Identify the role of the nurse in these specialty areas. The nurses
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The patients were sedated and placed in a side-lying position to allow the doctor easy access to the insertion site. The scope was inserted into the rectum using lubrication and advanced to the cecum portion of the large intestines. On the scope are small ports that allowed the doctor to manipulate the intestinal tract of the colon. The two ports developed a greater visualization by inflating the colon with air and washing debris from the walls with water. A third port of the scope provided an access for clamps to be inserted and retrieve a biopsy of abnormal tissue. (Lewis, Dirksen, Heitkemper, & Bucher, 2014, p. 881) The second procedure I was fortunate to observe was an esophagogastroduodenoscopy (EGD). The operation was performed with local anesthesia to the throat or sedation. The same type of scope was utilized, but instead of inserting through the rectum, the scope was inserted through the mouth. This procedure allowed the doctor to inspect the lining of the esophagus, stomach, and duodenum. Like the scope above, the doctor extracted biopsies, inflated the gastrointestinal tract, and cleansed the walls utilizing the scope. (Lewis, Dirksen, Heitkemper, & Bucher, 2014, p. …show more content…
The side rails were always raised when the patient’s bed was elevated and during transferring. The most significant time for the side rails to be up was when the patient was sedated and becoming aroused after sedation. This intervention helped prevent the occurrence of falls and the safety of the patient during and after the procedure. The next safety measure for the client practiced was identification. The patient was identified every time they were transferred to a different section of the unit. The admission nurse began the process by asking the patient to state their full name and date of birth to prove that the correct client was being admitted. The nurses in the operating room identified the patient for the second time and clarified with the patient what procedure was being performed. The patient was identified for the third time in the recovery room. The procedure was specified again and the interoperating nurse voiced any complications that occurred during the procedure with the recovery
Moreover, I will let the patient become familiar with any instruments such as a speculum, and demonstrate the tools that will be used to obtain tissue samples that would be used during the examination. Explaining the procedure is also a significant step; this will allow the patient have a sense of control during the examination as we ask and answer questions about their current state, that would help disseminate any concern they may have. Meanwhile, they can learn about what may happen, related to any body sensations or feelings they can experience during the procedure, all while the provider continues to develop rapport and patient’s trust
Depending on the time of surgery, the nurse may admit and discharge the same patient within the timeframe of his or her shift. The nurse obtains a history and physical (H&P) along with the progress notes from the operating surgeon or another licensed personnel written within the last twenty-four hours. The nurse sets the patient up with a peripheral intravenous line before surgery. He or she will interview the patient regarding the last time they ate and/or drank, what medications they take, and when the last medication dose was taken. The nurse also assesses the patient to see if he or she understands the procedure they are there for and asks if they have any questions or concerns. Depending on the health of the patient and what surgical procedure they will be subjected to, either a focused or full health assessment is performed. The nurse also makes sure that all labs pertinent to the patient have been obtained. These labs include a negative pregnancy test (or proof of a negative test within the last seven days) for any patient that could possibly be pregnant, even if the patient is currently menstruating, a finger-stick blood sugar test for all diabetic patients, a blood test for potassium levels for patients with end stage renal disease, and a prothrombin time or international normalized ratio test for patients on Coumadin. The nurse also makes sure that
Safety is focused on reducing the chance of harm to staff and patients. The 2016 National Patient Safety Goals for Hospitals includes criteria such as using two forms of identification when caring for a patient to ensure the right patient is being treated, proper hand washing techniques to prevent nosocomial infections and reporting critical information promptly (Joint Commission, 2015). It is important that nurses follow standards and protocols intending to patients to decrease adverse
Pay special attention to the face and hands, take the time to remove crusts of secretions from the eyes, nose, and mouth. The cleansing of the body includes perineal care and removal of the IV and catheter if they are present.The resident receives a new gown and new bed linens after their bath is complete. The draw sheet placement changes, meaning it is vertical instead of horizontal, so it is easier to move the resident onto the gurney. After replacing the sheets, the step of adding dentures per families request and placing a rolled towel under the chin to support the jaw to keep it closed before rigor mortis sets in. Next, closure of the eyes to the best of the Certified Nursing Assistant's ability and then combing of any stray hairs using warm water to keep them down if needed. After preparation of the resident, the next step is positioning, adjustment of the bed includes positioning it so that it is flat with the resident's arms placed straight at his or her sides. The resident's arms should lay outside of the blanket at each side of the
The surgery nurse tells the postop nurse about how the patient tolerated the surgery overall. The surgeon comes and look at the patient. The surgeon told the nurse the location, length, and how many stitches were associate with the wound. The nurse applied bactroban to the wound and monitored the wound for any bleeding. If there was bleeding to the wound area, then the nurse would tell the patient try not to talk since the surgery was on the lip. Postoperatively, the patient receives the information verbally about discharge instructions that are ordered by the surgeon, but the discharge papers may be handed to the family members. Since the patient is not fully competent after surgery the family member may be asked to assign the form with discharge instructions that were provided. The family is then given a copy of the discharge instructions, anesthesia paper, and the information about the procedure that was done. The planning that takes place when outpatients have surgery and are discharged home directly from the postop area is educating the patient about not driving within the next 24 hours, monitor the site for drainage, and depending on the surgery depends on the additional teaching that is needed. Also the nurse explains the medications that need to be taken, how long the medication needs to be taken for, and why the medication needs to be taken. The nurse tells the patient that if there are any changes cognitively or physically to call the doctor and if it’s an emergency then call 911. Phase 2 of surgery is known as the second part of recovery before the patient is able to go home. During Phase 2, the patient is closely monitored for any complications that may occur such as difficulty breathing, drainage at incision site and many more. The patient’s vital signs are taken every thirty minutes for an hour and if the
CLE can be used for the endoscopic evaluation of BE and for the accurate estimation of lesions’ extent and lateral margins to guide endoscopic treatment. CLE is not helpful in assessing the depth of invasion of early neoplastic lesions or in endoscopic surveillance after ablative or resective therapy. VLE is a new imaging modality with limited studies. However, early experience suggests that VLE appears to be a valuable imaging modality in its ability to identify sub-squamous Barrett’s esophagus and buried Barrett’s glands after mucosal ablation. Overall, CLE and VLE have not been adopted widely due to limited availability, high cost and need for specific operator training. The major limitation of all studies assessing the the role of CLE and VLE in screening and surveillance for BE is that they were all performed by expert endoscopists in tertiary referral centers with a population enriched in regard to the proportion of patients with dysplasia. Despite developments in advanced imaging techniques, these techniques are not included in standard surveillance guidelines and WLE with random biopsies remains the gold standard for BE
There has been debate on whether or not restraints are safe for patients. Tammelleo (1992) states that the use of restraints cause approximately 200 deaths every year, some of which include instances where a restraint was not necessary for the patient. Misuse is another important factor in the safeness and effectiveness of bed restraints. Misuse and tragic accidents have lead to the involvement of the FDA and recommendation calls that every medical institution must have and practice protocols for proper use of restraints (72). Tammelleo goes on to discuss recommended alternatives that should be explored before resorting to the use of restraints. Restraining patients may seem like the easier and quicker way to handle a patient, it is not always the best. Some alternative measures include wedging pads or pillows against the sides of a wheelchair to keep the patient in a good position, soften lights, provide soft music, spend extra ...
A barium enema is often down to evaluate their large intestine with an X-ray. The barium dye coats the lining of the bowel, creating a silhouette of their rectum, colon and a portion of their small intestine that's visible on an X-ray. This test is rarely done anymore because of the availability of colonoscopy and CT scanning (NDDIC, n.d.).
People have elective surgeries as well as emergency surgeries every day. The medication needed for these surgeries is administered by an anesthesiologist. Anesthesiologists must make sure that their patient gets the proper care they need for pain management. Anesthesiology is one of the highest paying jobs on the market. Accordingly, the schooling needed to become this highly trained doctor requires a lengthy time investment. On average, a student has to be in school eleven years to fulfill an anesthesiology degree. Job projections forecast a promising future for those seeking employment in this field of study. Anesthesiologists have very important jobs for the well being of people.
Tolan, Damian J.M., Armstong, Euan M., & Chapman, Anthony H. (2007). Replacing barium enema with ct colonography in patients older than 70 years: the importance of detecting extracolonic abnormalities. American Journal of Roentgenology, 189, 1104- 1111.
This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed in during my second year studying Adult diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rational behind this. During an admission I completed under the supervision of my mentor I was pre-assessing a 37 year old lady who had arrived to the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outline in this piece of work has learning disabilities it was imperative to identify any barriers with communication (Nursing standards 2006).
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record
In operating room three, there were three nurses doing different roles of surgical team. The first nurse was a “scrub nurse” that helped the doctor perform the surgery. She stood next to the bed and was the doctors “right hand women”. She helped
One of the many categories would be that of the circulating nurse. Ensuring that the operating room is set up correctly based on the preference of the surgeon, the circulating nurse makes sure all the necessary equipment’s are in place, functioning appropriately, likewise ready to go. In addition, the circulating nurse also verifies the patient identity, surgical site, and consent with the surgeon upon entering the operating room to make sure that they are all the same page, before proceeding with the schedule procedure. Yet another function of the circulating nurse is to make sure that the patient is positioned correctly on the surgical table, hooking up the basic suctions needed, and assisting the anesthesiologist or anesthetist during intubation. Moreover, monitoring the overall condition of the
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).