General

Synonym/Acronym:
N/A

Rationale
To identify cellular changes associated with tumors or organisms that result in respiratory tract infections, such as Pneumocystis jiroveci.

Patient Preparation
For specimens collected by suctioning or expectoration without bronchoscopy, there are no food, fluid, activity, or medication restrictions unless by medical direction. Instruct patients who will undergo bronchoscopy or biopsy that to reduce the risk of aspiration related to nausea and vomiting, solid food and milk or milk products are restricted for at least 6 hr, and clear liquids are restricted for at least 2 hr prior to general anesthesia, regional anesthesia, or sedation/analgesia (monitored anesthesia). Patients may be required to be NPO after midnight. The American Society of Anesthesiologists has fasting guidelines for risk levels according to patient status. More information can be located at www.asahq.org.

Regarding the patient’s risk for bleeding, the patient should be instructed to avoid taking natural products and medications with known anticoagulant, antiplatelet, or thrombolytic properties or to reduce dosage, as ordered, prior to the procedure. Number of days to withhold medication is dependent on the type of anticoagulant. Note the last time and dose of medication taken. Protocols may vary among facilities.

Patients on beta blockers before the surgical procedure should be instructed to take their medication as ordered during the perioperative period.

Normal Findings
(Method: Macroscopic and microscopic examination) Negative for abnormal cells, fungi, ova, and parasites.

Critical Findings and Potential Interventions

• Identification of malignancy

Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.

Specific infectious organisms are required to be reported to local, state, and national departments of health. Lists of specific organisms may vary among facilities. State health departments provide information regarding reportable diseases, which can be accessed at each state health department Web site. The CDC provides information regarding national notifiable diseases at https://ndc.services.cdc.gov/search-results-year/.

If the patient becomes hypoxic or cyanotic, remove catheter immediately and administer oxygen.

If patient has asthma or chronic bronchitis, watch for aggravated bronchospasms with use of normal saline or acetylcysteine in an aerosol.