Surgical Nursing: Endoscopic Procedures and Nurse's Interventions

Endoscopic Procedures:

• Definition: Examining the interior of a body canal or hollow organ using a flexible, lighted instrument called an endoscope.
• Indications:
  • Diagnostic purposes (e.g., upper/lower gastrointestinal endoscopy, bronchoscopy)
  • Therapeutic purposes (e.g., removal of polyps, dilation of strictures)
• Contraindications:
  • Coagulopathy or active bleeding
  • Severe cardiopulmonary disease
  • Acute bowel obstruction or perforation
• Nursing Responsibilities:
  • Before the procedure:
    • Obtain informed consent
    • Assess patient's medical history and current condition
    • Prepare patient (e.g., fasting, bowel preparation)
    • Ensure appropriate equipment and supplies are available
  • During the procedure:
    • Monitor patient's vital signs and provide comfort measures
    • Assist physician with the procedure as needed
    • Observe for and report any complications
  • After the procedure:
    • Monitor patient for any immediate complications
    • Provide post-procedure instructions and education
    • Document the procedure and patient's response
• Complications:
  • Bleeding
  • Infection
  • Perforation
  • Adverse reaction to sedation

Biopsy:

• Definition: Removing a small sample of tissue from the body for analysis.
• Indications:
  • Diagnosis of various conditions (e.g., cancer, infection, inflammation)
  • Monitoring of disease progression or treatment response
• Contraindications:
  • Bleeding disorders or anticoagulant therapy
  • Infection at the biopsy site
  • Inability to tolerate the procedure
• Nursing Responsibilities:
  • Before the procedure:
    • Obtain informed consent
    • Assess patient's medical history and current condition
    • Prepare patient (e.g., fasting, medication adjustments)
    • Ensure appropriate equipment and supplies are available
  • During the procedure:
    • Monitor patient's vital signs and provide comfort measures
    • Assist physician with the procedure as needed
    • Observe for and report any complications
  • After the procedure:
    • Monitor patient for any immediate complications
    • Provide post-procedure instructions and education
    • Document the procedure and patient's response
• Complications:
  • Bleeding
  • Infection
  • Pain
  • Pneumothorax (for lung biopsies)

Thoracotomy:

• Definition: A surgical procedure that involves making an incision into the chest wall to access the thoracic cavity.
• Indications:
  • Diagnosis and treatment of thoracic diseases (e.g., lung cancer, lung abscess, pleural effusion)
  • Trauma management (e.g., repair of a ruptured diaphragm)
• Contraindications:
  • Severe cardiopulmonary disease
  • Uncontrolled coagulopathy
  • Inability to tolerate the procedure
• Nursing Responsibilities:
  • Before the procedure:
    • Obtain informed consent
    • Assess patient's medical history and current condition
    • Prepare patient (e.g., skin preparation, pain medication)
    • Ensure appropriate equipment and supplies are available
  • During the procedure:
    • Monitor patient's vital signs and provide comfort measures
    • Assist surgeon with the procedure as needed
    • Observe for and report any complications
  • After the procedure:
    • Monitor patient for post-operative complications (e.g., bleeding, infection, respiratory distress)
    • Provide post-operative care (e.g., pain management, respiratory therapy, wound care)
    • Document the procedure and patient's response
• Complications:
  • Bleeding
  • Infection
  • Respiratory distress
  • Nerve damage
  • Persistent pain