Lesson 19 — Gastroenterology Assisting

1. Sanitize your hands and assemble all required equipment and supplies.

   Purpose

   To ensure infection control.

2. Identify the patient by obtaining his or her full name and date of birth; introduce yourself; and explain the procedure.
3. Give the patient an examination gown. Instruct him or her to remove all clothing below the waist and to put on the gown with the opening to the back. Provide a drape for additional privacy.
4. Assist the patient onto the table. When the provider is ready, place the patient in the appropriate position for the type of examination ordered.
5. Drape the patient so that only the anus is exposed. A fenestrated drape (drape with a circular opening over the anus) may be used in place of the rectangular drape.
6. Put on gloves and assist the provider as requested during the examination, including: Handing the provider supplies, Collecting specimens by holding the fecal occult blood card to accept the sample, The provider placing a thin smear of fecal material inside Box A, The provider applying a second sample from a different part of the stool inside Box B, Closing the cover and disposing of contaminated supplies in the biohazard waste container as you are given them by the provider.
7. On completion of the examination, remove your gloves and dispose of them in the biohazard waste container. Sanitize your hands, and assist the patient into a sitting position.
8. Wait 3 to 5 minutes before developing the sample.
9. Put on gloves and open the flap in the back of the card. Apply 2 drops of fecal occult blood test developer directly over the smear.
10. Interpret the results in 60 seconds.

    Purpose

    The fecal occult blood test is negative if no trace of color is detectable on or at the edge of the smear; it is positive if any trace of blue is seen on or at the edge of the smear.

11. Sanitize and disinfect the work area and all equipment used. Dispose of the gloves in the biohazard waste container and sanitize your hands.

    Purpose

    To ensure infection control.

12. Record the procedure and any pertinent information in the patient's health record.

    Purpose

    Procedures that are not recorded are considered not done.

13. Give the patient a kit for collecting stool samples as ordered by the provider. Typically, the provider orders a sample from three different bowel movements.
14. The patient must follow the recommended medication restrictions and dietary guidelines throughout the testing period because false-positive results can occur if the recommended medication and dietary restrictions are not followed.
15. Store the kit in the bathroom at home or carry it with you while you are away from home until the three different stool samples have been collected.
16. Write your name and other required information on the front of the collection cards.
17. Cover the toilet with plastic wrap or use a toilet cap to collect the stool specimen.

    Purpose

    Stool samples from toilet bowl water can cause errors in the test result.

18. Use one of the applicator sticks to collect a small fecal sample and apply a thin smear inside Box A.
19. Reuse the applicator to obtain another sample from a different part of the stool and apply it to Box B.
20. Close the cover and label the card with the date and time collected.
21. Store cards away from heat, light, and strong chemicals (e.g., bleach). Do not place in a plastic bag.

    Purpose

    Strong chemicals can affect the slide. The stool sample must air dry to be processed properly.

22. Repeat this procedure for the next two bowel movements, as ordered by the provider, using a different card for each sample.

    Purpose

    To test multiple stool samples for minute amounts of bleeding.

23. After collecting all samples as ordered, seal the test envelope and return the kit to the provider's office. Do not send stool samples in the mail unless you have a special envelope from the provider.

    Purpose

    To prevent contamination of the mail.

Knowledge-check items

Click an answer to lock it in — you'll see the rationale below. Reset any time to re-attempt. Items originally formatted as true/false, fill-in-blank, or drag-and-drop have been normalized to multiple choice; the source format is noted in the eyebrow.

L19-01 · Fecal Specimen