Gastrointestinal Nursing.pdf

Nursing care during gastroscopyDiagnostic Procedures and Tests in Gastroenterology 141During gastroscopy the nursing responsibilities include the maintenance ofthe patient’s oral airway, suctioning secretions and regurgitated material whennecessary from the pharynx. Nasal oxygen should be used to treat hypoxia,and resuscitation equipment should be immediately available in the eventof cardiopulmonary complications. The nurse should monitor the patient’soxygen saturation and vital signs regularly and observe the patient for signsof bleeding, vomiting, change in vital signs, pain and abdominal distension.Patients should be fasted for at least four hours prior to gastroscopy, longer ifthey have eaten a large meal.Although gastroscopy is generally regarded as a safe procedure, adverseevents can occur, including:• respiratory depression• effects of sedation• perforation of the oesophagus, stomach or duodenum• haemorrhage related to trauma and perforation• pulmonary aspiration of blood or secretions, or regurgitation of gastriccontents• cardiac arrhythmia• infection• allergic reaction to the anaesthetic or intravenous medicationsThe rate of adverse events and complications increases when therapeuticmanoeuvres are performed. Patients at the highest risk during gastroscopy areolder people and those with advanced cardiac, pulmonary, hepatic or centralnervous system disease.Endoscopic retrograde cholangiopancreatography (ERCP)ERCP uses a combination of endoscopic and radiological techniques to visualisethe biliary and pancreatic ducts. It involves the injection of a contrast materialinto the biliary and pancreatic systems followed by radiological screening.Two different contrasts are used: low iodine for the common bile duct andhigher iodine contrast for the pancreatic duct.ERCP is indicated for the following:• Signs and symptoms of pancreatic malignancy.• Evaluation of acute, recurrent pancreatitis.• Removal of retained common bile duct stones.• Unexplained chronic abdominal pain of suspected biliary or pancreaticorigin.