TEST WITH ACTUAL NURSING INTERVENTIONS/

DATE RATIONALE CLINICAL SIGNIFICANCE

NORMAL VALUES RESULT RESPONSIBILITIES

.
Identify bowel
June Flexible Rectal Cancer Rectal Cancer stage III Preparations:
obstruction,
10, fiberoptic stage III A A 1. Obtain sterile specimen
carcinoma of
2010 Sigmoidoscop containers if a biopsy is planned.
sigmoid colon,
y Biopsy: Biopsy: 2. The client should disrobe below
celiac sprue,
with biopsy Adenocarcino Adenocarcinoma the waist or wear a gown.
Chron’s disease,
ma
diverticulitis, and
Procedure:
help diagnose
1. The client is placed in the left
causes of
lateral position.
malabsorption.
2. Monitor blood pressure, HR, and
oxygen saturation rate by pulse
oximeter before analgesic and
sedative is given and then every 5
mins during the procedure.
3. An analgesic or sedative may be
administered. Monitor respiration
status continually after sedation.
4. The sigmoidoscope is lubricated
and inserted into the anus and
rectum and then slowly advanced
into the sigmoid colon.
5. During the procedure, biopsy
specimen and photographs may be
taken and suction used to remove
excess secretions.

Postprocedure care:
1. Assess for side effects of the
sedative: hypotension, depressed
respirations, and bradycardia.
2. Continue the assessment of the
respiratory status. If deep sedation
was used, follow institutional
protocol for postsedation monitoring.
Typical monitoring includes
continuous ECG monitoring and
pulse oximeter, with continual
assessment (every 5-15 minutes) of
airway, vital signs, and neurologic
status until the client is lying quietly
awake, is breathing independently,
and responds to commands spoken
in a normal tone.

Client and family teaching:

• This test is performed to

evaluate the colon for several
different disoreders.

• Consume a full liquid diet the

evening before the test.

• Laxatives may be prescribed

to be adminstered the night
before the test with or without
an enema or suppository
1hour the test.

• The urge to defecate as the

sigmoidoscopy is inserted into
the rectum is normal.

• The procedure takes

approximately 30 minutes.
 • Resume normal activities and
diet as soon as the patient
feels ready.

• Call a physician if the temperature

is higher than 1010 F (38.30 C), or if
having trouble breathing experi
encing stomach pain, nausea, or
bright red rectal bleeding.

CEA is a helpful
marker in
establishing
prognosis,
Serum CEA determining Result: 3.1830 NORMAL • Preparation:
(Carcinoembry effectiveness of mg/ml
1. Tube: red topped or serum
onic antigen) therapy, and
separator for serum. Lavender
Normal values: recognizing
topped for plasma.
<5 mg/ml recurrent disease in
clients with 2. May be drawn during
adenocarcinoma, hemodialysis.
especially those
arising in the colon
 or stomach. CEA is • Procedure:
a marker of choice
1. Draw a 1ml venous blood sample
for monitoring
without hemolysis.
colorectal
carcinoma, and 2. specimen may be kept at room
levels above temperature or refrigerated for 24
15ng/ml indicate hours but should be frozen if assay
high-rsik clients and not performed within 24 hours after
the need for collection.
adjuvant or
neoadjuvant
chemothrerapy. • Client and family teaching:

1.Results are usually available in 1-3

working days.

• Preparation:
Serum
Alanine 1. Tube: Red topped, red/gary
ALT(Alanine
aminitransaminase
Aminotransami topped, or gold topped.
(ALT) is an enzyme NORMAL
nase)
primarily produced
2. List medications taken by the
Normal values: by the liver and
 14-63 U/L found in certain Result: 18.0 client within the last 3 days in
body fluids (such as U/L laboratory requisition.
bile, cerebrospinal
fluid, plasma, and 3. Do NOT draw during
saliva) and in the
hemodialysis.
heart, liver, kidneys,
pancreas, and
• Procedure:
skeletal muscle. It
acts as a catalyst in
1. Draw a 1-mL blood sample.
the transmission
reaction that is • Postprocedure care:
necessary for amino
acid production. 1. The specimen may be refrigerated
Serial
but not frozen.
measurements help
track the course of
hepatitis. This test • Client and family teaching:
may also be used by
1. Results are normally available ithin
blood banks or tp
screen for hapatitis 12 hours.
in samples of donor
blood.

Computed • Preparation:
Tomography
Scanning (CT CT provides cross- 1. CT may be performed with or
scan) sectional images of without oral or intravenous contrast,
abdominal organs but the enhancement of the study is
and structures. Ct is
a valuable tool for There is greater with use of a contrast agent,
detecting and thickening of
2. Any allergies to contrast , iodine,
localizing many the right
shellfish; the patient's current serum
inflammatory anterolateral
creatininen level, and urine human
conditionsin the aspect of the
chrionic gonatropin must be
colon, such as rectal wall by
deteremined before administration of
appendecitis, about 4cm
a contrast agent.
diverticulitis, commencing
regional enteritis, 8cm from the Patients allergic to the contrast agent
and ulcerative anal velge with must be premedicated with !V
colitis, as well as narrowing of prednisone 24 hours, 12 hours, and
evaluating the the diameter of 1 hour bafore hour before scan.
abdomen for the proximal
• In addtion,vrenal protective
diseases of the liver, rectum.
measures include the administration
spleen, kidney,
of Iv sodiumbicarbonate and
pancreas, and pelvic
Mucomyst are free radical
organs, and
scavengers that sequester the
structural
contrsat byproductsthat are
abnormalities of the
detructive to renal cells.
abdominal wall.