Gastrointestinal Nursing.pdf

Diagnostic Procedures and Tests in Gastroenterology 149Liver function testsLiver function tests may be carried out on blood, urine and faeces to detect thelevels of substances manufactured by the liver as well as to estimate otherfunctions of the liver (i.e. excretion). Liver function tests are usually defined asthe measurement of serum levels of:• albumin• bilirubin• aminotransferase• alkaline phosphotase• γ-glutamyltransferaseSerum albuminSerum albumin is a good indicator of chronic liver disease. It is synthesised bythe liver and its levels fall in chronic liver disease.ConclusionNurses working in gastroenterology are increasingly being enabled, throughspecialist and nationally recognised courses, to undertake training and extendtheir practice as nurse endoscopists. These developments are in line withUK government policy, which seeks to extend the clinical capabilities of nursesgenerally and also in line with the development of the nurse consultantrole.Extending nursing practice into invasive and diagnostic procedures such asendoscopy raises several issues for nurses, including accountability, relationshipswith the medical and surgical professions and the knowledge baserequired for such practice. It is already clear that nurses are able to carry outendoscopy safely and it is likely that there will be a major expansion in thisrole. In addition to being able to undertake this devolved medical procedure,nurses are ideally placed to undertake it as these invasive procedures areassociated with a great deal of anxiety in patients regarding the procedureitself and the possible outcome in terms of diagnosis – especially of malignantconditions. The nurse endoscopist, in addition to performing the endoscopy,is able to offer support through detailed and clear explanations to the patientof what they are likely to experience, and for minor conditions such as haemorrhoidscan carry out certain treatments and offer ongoing advice about dietand lifestyle which may help to alleviate further problems. Nurses should alsohave a thorough understanding of the medical and surgical roles in relation tothe possible outcomes of endoscopy or the need for further, more invasiveprocedures which they are not competent to carry out.