An adult client with suspected cirrhosis is scheduled for a bedside percutaneous liver biopsy. To minimize the risk of procedural and post-procedural complications, arrange the following nursing actions in the correct chronological sequence. (Place the first action at the top and the final action at the bottom.)
- 1Review the client's most recent prothrombin time (PT), INR, and platelet count.
- 2Position the client supine with their right arm resting behind their head.
- 3Instruct the client to exhale completely and hold their breath during needle insertion.
- 4Apply direct, firm pressure to the biopsy insertion site.
- 5Assist the client into a right lateral decubitus position.
Answer
The correct sequence begins with reviewing coagulation labs, followed by supine positioning with the right arm elevated, instructing the client to exhale and hold their breath during insertion, applying immediate pressure to the site, and finally placing the client in a right lateral position.
The correct sequence prioritizes pre-procedural safety by first verifying coagulation status. Next, the client is positioned to maximize access while minimizing anatomical risk. Instructing the client to exhale and hold their breath protects the diaphragm and lungs. Finally, applying immediate manual pressure followed by a right lateral position provides necessary continuous compression to prevent the most common severe complication: hemorrhage.
Step-by-Step Solution
Key Concept
Reduction of Risk Potential during Percutaneous Liver Biopsy