Medical Surgical Nursing

NURSING ACTIVITIES RATIONALE

 Ascertain that results of coagulation
tests (prothrombin time, partial
thromboplastin time, and platelet
count) are available

a) and that compatible donor blood is

available.

 Check for signed consent; confirm that

informed consent has been provided.

 Measure and record the patient‘s pulse,

respirations, and blood pressure

immediately before biopsy.

 Describe to the patient in advance:
steps of the procedure;

 Support the patient during the

procedure.

 Expose the right side of the patient‘s
upper abdomen (right hypochondriac).

 Instruct the patient to inhale and exhale

deeply several times, finally to exhale,

and to hold breath at the end of

expiration. The physician promptl

introduces the biopsy needle by way of

the transthoracic (intercostal)

transabdominal (subcostal) route,

penetrates the liver, aspirates, and

withdraws.

 Many patients with liver disease have

clotting defects and are at risk for

bleeding.

 2. Procedure should be done with

agreement of patient

 Pre-biopsy values provide a basis on

which to compare the patient‘s vital

signs and evaluate status after the

procedure.

 Explanations allay fears and ensure

cooperation.

 Encouragement and support of the

nurse enhance comfort and promote a

sense of security.

 The skin at the site of penetration will

be cleansed and a local anesthetic will

be infiltrated.

 Holding the breath immobilizes the

chest wall and the diaphragm;

penetration of the diaphragm thereby is

avoided, and the risk of lacerating the

liver is minimized.

Post-procedure