Position given to patient during sigmoidoscopy is?

Appeared in: HPSSC Staff Nurse - 2021

Explanation

The left lateral position, specifically the Sims' variation, is the standard for sigmoidoscopy.
This position straightens the rectosigmoid junction, which allows the endoscope to be inserted and advanced more easily and with less discomfort for the patient.
As shown in the provided image, the patient lies on their left side with the right knee flexed towards the chest, which optimizes the angle for the procedure.
Gravity helps in this position by causing the sigmoid colon to fall away, providing a better view for the endoscopist.

Option A: The supine position (lying on the back) does not allow access to the rectum and anus, making it impossible to perform a sigmoidoscopy.
Option B: The prone position (lying on the stomach) is generally not used for sigmoidoscopy as it can be uncomfortable and does not provide the optimal angle for scope insertion compared to the left lateral position.
Option C: The lithotomy position is not the standard for a routine flexible sigmoidoscopy. It is more invasive in terms of positioning and is typically reserved for other types of procedures.

Clinical Relevance

Nursing practice connection: Use the key finding related to Patient positioning for lower gastrointestinal endoscopic procedures to guide bedside assessment, documentation, and the next nursing action.
Proper patient positioning is a critical nursing responsibility that directly impacts the success, safety, and comfort of a procedure.
For sigmoidoscopy, correct positioning prevents patient discomfort, reduces the risk of injury (like perforation), and facilitates a quicker, more effective examination.
Nurses must be able to explain the position to the patient, assist them into it, and monitor their vital signs and comfort level throughout the procedure, watching for signs of a vasovagal response (dizziness, bradycardia, pallor).

How to Approach the Question

First, identify the key procedure in the question: 'sigmoidoscopy'.
Recall the anatomical location involved: the sigmoid colon, which is the S-shaped lower part of the large intestine leading to the rectum.
Think about how to best access this area. The entry point is the anus.
Evaluate the options based on providing access to the anus and straightening the path to the sigmoid colon.
The left lateral (Sims') position is specifically designed for rectal access. The supine position offers no access. The prone position is awkward. The lithotomy position is possible but more common for other procedures.
Select the option that represents the standard, most effective, and most comfortable position for this specific examination.

Concept Tested & Keywords

Concept Tested: Patient positioning for lower gastrointestinal endoscopic procedures.
Stem keywords: Position, patient, sigmoidoscopy
Lead-in keywords: is

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E6 Nursing Fundamentals Taylor p. 210-212

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 92-94

Practise the full HPSSC Staff Nurse - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.