A nurse is caring for a client who has been scheduled for endoscopic retrograde cholangiopancreatography (ERCP) the following day. When providing education for this client, the nurse should describe what information regarding this diagnostic procedure?

Choice A reason: ERCP is an endoscopic procedure, not an open surgical one. It involves passing a flexible fiberoptic endoscope through the esophagus and stomach into the duodenum. Therefore, there is no need for a surgical incision in the right upper quadrant, which would be characteristic of an open cholecystectomy or laparotomy. Choice B reason: ERCP is an invasive procedure that requires the patient to remain still and suppresses the gag reflex while the scope is manipulated. Conscious sedation or monitored anesthesia care is used to ensure patient comfort and safety during the insertion of the endoscope and the subsequent cannulation of the biliary and pancreatic ducts. Choice C reason: Patients must remain NPO (nothing by mouth) for at least 6 to 8 hours prior to an ERCP. An empty stomach is essential to provide a clear field of vision for the endoscopist and, more importantly, to prevent the risk of aspiration while the patient is under the influence of sedative medications. Choice D reason: ERCP is specifically designed to visualize the biliary tree and pancreatic ducts (cholangiography and pancreatography). The appendix and the cecum are located in the lower gastrointestinal tract. Better visualization of those structures would be achieved through a colonoscopy, not an upper endoscopic procedure like an ERCP.