Biopsy, Various Sites (Bladder, Bone, Intestinal, Kidney, Liver, Lung, Lymph Node, Muscle, Prostate, Skin, Thyroid)

General

Synonym/Acronym:
N/A

Rationale
To assist in diagnosing cancer or other tissue abnormality.

Patient Preparation
There are no activity restrictions unless by medical direction. Explain that diet is restricted to clear liquids from the day prior to the day of an intestinal biopsy. Instruct all patients 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 asked 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 of tissue) No abnormal tissue or cells. No infectious organisms.

Critical Findings and Potential InterventionsGeneral

  • Assessment of clear margins after tissue excision
  • Classification or grading of tumor
  • Identification of malignancy
  • 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/.

Lung

  • Shortness of breath, cyanosis, or rapid pulse during the procedure must be reported immediately. Any postprocedural decrease in breath sounds noted at the biopsy site should be reported immediately


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.

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