1-22. STOOL EXAM
a. General. Stool samples can be examined on the ward and in the laboratory
to determine the presence of substances that aid in diagnosis. For example:
(1) On the ward, nursing personnel can determine the color, consistency,
and amount of stool. The presence of unseen blood (occult) can be determined with a
simple test.
(2) In the laboratory, tests can be performed to determine the presence of
fat, urobilinogen, ova, parasites, bacteria, and other substances.
b. Nursing Implications.
(1) Nursing personnel should consider the following information when
assessing and documenting information related to a patient's bowel movements.
(a) Small, dry, hard stools may indicate constipation or fecal impaction.
(b) Diarrhea may indicate fecal impaction or fecal mass, or it may be
the result of a disease process (such as colitis or diverticulitis) or a bacterial infection
(such as dysentery).
(2) Nursing personnel should consider the patient's diet when assessing
and documenting the character of a patient's stool.
(a) Black, tarry stools may be the result of upper GI bleeding, iron
supplements, or diet selection (eating black licorice, for example).
(b) Reddish colored stools may be the result of bleeding in the lower GI
tract or diet selection (eating carrots or beets, for example).
1-23. ENDOSCOPY
a. General. Endoscopy is a visual examination of the interior through the use of
special instruments called endoscopes. In relation to the digestive system, the term
endoscopy is used to describe visual examination of the inside of the GI tract. There
are many different types of endoscopes, each designed for a specific use. Generally,
the scope consists of a hollow tube with a lighted lens system that permits
multi-directional viewing. The scope has a power source and accessories that permit
both biopsy and suction.
b. Pre-Procedural Nursing Implications.
(1) Endoscopic procedures are invasive, and therefore require a formal,
signed consent form.
MD0918
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