Polyethylene glycol-electrolyte solution (GoLYTELY) is prescribed for the female client scheduled for a colonoscopy. The client begins to experience diarrhea following the administration of the solution. What action by the nurse is appropriate?
A. Start an IV infusion
B. Administer an enema
C. Cancel the diagnostic test
D. Explain that diarrhea is expected
Correct Answer: D. Explain that diarrhea is expected.
The solution GoLYTELY is a bowel evacuant used to prepare a client for a colonoscopy by cleansing the bowel. The solution is expected to cause mild diarrhea and will clear the bowel in 4 to 5 hours. Polyethylene glycol electrolyte (PEG) is essential for a wide range of bowel preparation, with advantages such as high security, reliable effect, no dehydration, and electrolyte disturbance.
Option A: Starting an IV is unnecessary. Surveys, such as those conducted by Seo et al., have shown that colon cleanliness was the highest at time intervals of 3–5 h after a one-time oral administration of 4 L of PEG solution, whereas colon cleanliness was significantly decreased at time intervals of <3 or >7 h.
Option B: Administering an enema would be inappropriate. Bacteria in intestinal feces account for 20%–30% of the solid weight of feces. This also accords with earlier observations that the PEG solution can only effectively remove solid residues in feces and has no significant effect on colonic bacteria and flora.
Option C: Cancelling the test would be inappropriate. PEG solution combined with lactulose improves the quality of bowel preparation in patients with long interval P-C, which allows patients to have no restriction on the time of colonoscopy, and benefits more patients who need a colonoscopy.
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