Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates
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This article provides the reader with information and education regarding the use of capnography for both adult and pediatric patients undergoing procedural sedation during endoscopy by: reviewing the basics of capnography, in addition to the physiology of ventilation and oxygenation; illustrating how capnography may provide an earlier warning of hypoxemia than does pulse oximetry; briefly discussing current guidelines for procedural sedation and the potential role of capnography; and reviewing clinical situations causing changes in the capnogram waveforms and the nursing interventions that should be made in response to such changes.
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Review Comparative Study
The stool DNA test: an emerging technology in colorectal cancer screening.
The stool DNA test is considered an emerging technology in screening for colorectal cancer. The stool DNA test detects DNA markers which are shed from cells of premalignant adenomas and cancers into the stool. Potentially, both preclinical and clinical colorectal cancer may be detected. ⋯ Some limitations of the stool DNA test include the need for clinical studies in average-risk populations and marker refinement. An automated testing system may help reduce costs and turnaround times. Despite recognized limitations, the stool DNA test is a promising new diagnostic tool with the potential to improve effectiveness of colorectal cancer screening.
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Comparative Study
Development of the Society of Gastroenterology Nurses and Associates Minimum Data Set: an evidence-based resource.
The Society for Gastroenterology Nurses and Associates (SGNA) has developed a Minimum Data Set identifying the essential elements necessary to document delivery of patient care in the gastrointestinal endoscopic setting. Standardized information, such as a minimum data set, for facilitating communication among practitioners is believed to enhance patient outcomes. The SGNA Minimum Data Set was developed for "public" use to facilitate quality patient outcomes and to enhance the education, research, and clinical practice of GI nurses. ⋯ Focus groups with members from around the U. S. verified the validity of the Minimum Data Set. The SGNA Minimum Data Set can be used by healthcare institutions, industry, and individuals to facilitate the capture and analysis of standardized data for the purpose of improving GI patient outcomes and enhancing delivery of nursing care.
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An abdominal radiograph is considered the "gold standard" for determining the position of flexible small-bore nasogastric/orogastric tubes. However, placement must be checked frequently while a tube is in place, and the summative radiation risk of multiple radiographs, as well as their expense, make the development of adequate bedside placement-locating methods imperative. Several methods of detecting tube placement have been investigated in adults, including: aspirating gastric contents and measuring the pH, bilirubin, pepsin, and trypsin levels; examining the visual characteristics of aspirate; placing the proximal end of the tube under water and observing for bubbles in synchrony with expirations; measuring the carbon dioxide level at the proximal end of the nasogastric/orogastric tube; auscultation for a gurgling sound over the epigastrium or left upper quadrant of the abdomen; and measuring the length from the nose/mouth to the proximal end of the tube. ⋯ Research on gastric tube placement in children is relatively new because children are challenging to study in that they are considered a vulnerable population. This review of the literature includes results of both adult and pediatric studies. Tube placement error rates varied from 1.9% to 89.5% in adults and between 20.9% and 43.5% in children.