An 85-year-old male patient is aware of the need for a colonoscopy; however, he has a history of severe electrolyte imbalances associated with bowel preps for diagnostic tests. The nurse realizes that this patient should probably:
1. Talk to his doctor about not having the colonoscopy because the prep might be harmful.
2. Have the colonoscopy and take medication afterward for the electrolyte imbalances.
3. Wait a year and have the colonoscopy done then.
4. Have a flexible sigmoidoscopy instead.
Talk to his doctor about not having the colonoscopy because the prep might be harmful.
Rationale: The age to discontinue colorectal cancer screening is unknown; however, the burden of screening may outweigh the potential benefits in patients with advanced age and comorbid conditions that limit life expectancy. The patient should discuss the benefits and potential harms associated with the colonoscopy with his health care provider. There is not enough information to determine that the patient should have the colonoscopy and be treated for electrolyte imbalances afterward. It is not a recommendation to wait a year and have the colonoscopy done then. It is not a U.S. Preventive Services Task Force recommendation to substitute a flexible sigmoidoscopy for a colonoscopy.
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