A charge nurse in an ambulatory endoscopy center is conducting a pre-procedure telephone interview with a 68-year-old client scheduled for a routine screening colonoscopy the following morning. The client's electronic health record indicates the client has not received a tetanus booster in 15 years. During the call, the client's spouse takes over the phone and reports that the client has been experiencing sudden, severe disorientation and visual hallucinations over the past 24 hours. Based on this information, which conclusion by the nurse regarding the client's health screening is most appropriate?
- AThe scheduled colonoscopy and the overdue tetanus vaccination are both secondary prevention measures that should be prioritized during tomorrow's appointment.
- BThe recent onset of disorientation is an expected cognitive change associated with the aging process and is not a contraindication for the screening procedure.
- The screening colonoscopy must be deferred, and the client should be directed to seek immediate diagnostic evaluation for the acute disorientation.Answer
- DWhen the client arrives, the nurse must confirm the efficacy of the bowel preparation by palpating the abdomen for distention prior to auscultating for bowel sounds.
Answer
The screening colonoscopy must be deferred, and the client should be directed to seek immediate diagnostic evaluation for the acute disorientation.
Health screenings (such as a routine colonoscopy) are secondary prevention measures designed for early detection in asymptomatic, stable clients. A sudden onset of severe disorientation and hallucinations over a 24-hour period indicates an acute, potentially life-threatening condition (such as delirium, severe infection, or an acute neurological event). Routine health screenings must immediately be deferred until the acute medical issue is diagnostically evaluated and the client is stabilized.
Step-by-Step Solution
Key Concept
Prioritization of Health Screenings vs. Acute Diagnostic Evaluation