Colonoscopy: preparation and monitoring
The quality of the preparation determines whether the examination is usable. An incomplete preparation means a repeat examination and a lesion that goes unseen. Before: clear fluids only for the period prescribed, nothing red or purple because the colour is mistaken for blood. The bowel preparation is taken in divided doses, the second part on the morning of the procedure. Verify what the client actually drank rather than what was prescribed. Medications to raise with the prescriber: anticoagulants and antiplatelets, iron supplements to be stopped several days earlier because they stain the mucosa, insulin and oral hypoglycemics that must be adjusted for the fasting period. After: monitor for the signs of perforation and of bleeding, which are the two complications that matter. Increasing abdominal pain, distension, fever, tachycardia, rectal bleeding beyond a small amount. Cramping and gas are expected and resolve. The client received sedation: no driving, no important decisions and no return home alone for the rest of the day. This must be arranged before the appointment, not discovered afterwards.