Gastrointestinal Nursing.pdf

140 Chapter 10the optic system consists of a one-piece video camera that transmitsimages directly to a television screen with no need for fibreoptics.• A control head that houses the lenses, controls for manoeuvring the tip upand down and from side to side, and valves that regulate irrigation, air orcarbon dioxide insufflation and suction.• Channels for air and water flow.• A suction/biopsy channel that allows the passage of accessory instruments,such as biopsy forceps, cytology brushes, polypectomy snares, laser fibresor stents. The suction channel also allows for suctioning fluid thatobstructs the endoscopist’s vision.GastroscopyGastroscopy, or oesophogastroduodenoscopy, uses a flexible endoscope lessthan 10 mm in diameter, which is passed directly into the upper gastrointestinaltract. The entire oesophagus and stomach and proximal duodenum can bevisualised. Larger diameter gastroscopes with larger suction channels are usedfor therapeutic procedures.Gastroscopy allows the physician or nurse endoscopist to diagnose anddocument gastrointestinal disorders through the use of direct vision and videophotography.Diagnostic gastroscopy is generally indicated for evaluating:• dysphagia or odynophagia• dyspepsia• gastro-oesophageal reflux symptoms unresponsive to medical therapy• haematemisis/melaena• oesophageal or gastric varices• oesophagitis or gastritis• gastric and peptic ulcers• chronic abdominal pain• suspected polyps and cancer• removal of ingested foreign bodies• acute injury following caustic ingestion• management of achalasiaGastroscopy is generally not indicated for evaluating:• symptoms which are considered functional in origin• metastatic adenocarcinomaPrior to gastroscopy, patients require thorough medical and nursing assessmentwith special attention given to any history of drug reactions, bleedingdisorders or associated cardiac, pulmonary, renal or hepatic disease.