Nursing Management1. Risk for ineffective gastrointestinal

perfusion Monitor for perforation and peritonitis No laxatives or enemas Monitor vital signs Maintain IV fluid replacement2. Pain Ice to RLQ – NO HEAT

Functional Health Patterns – pages 934-936Physical Assessment – pages 936-939

BARIUM ENEMA/LOWER GI

COLONOSCOPY

Virtual colonoscopy• Uses CT scanner and computer software to

look inside the body without having to insert the colonoscope

• Needs same prep as we just discussed• Small tube is placed in rectum, so air can be

induced• CT scan – lay on back and then stomach• Takes about 10-20 minutes• Free to leave afterwards

PROCTOSIGMOIDOSCOPY

FECAL ANALYSIS

CEA Levels- carcinoembryonic antigen

Protein secreted by cells of GI tract Elevated with colon cancers, liver, or

pancreatic cancers Monitors the effectiveness of treatment.

Geriatric considerations

• Constipation due to: lack of bulk in diet, decreased fluid intake, decreased activity, laxative abuse, intestinal muscle tone decreases, and avoidance of need to defecate

• Fecal incontinence• Rectal prolapse

Diarrhea

Fecal Incontinence

• Bowel Incontinence• Risk for impaired skin integrity• Body image distrubance• Risk for caregiver role strain• Self-care deficit – toileting• Social isolation