Biopsy

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Study Tools For Biopsy

Skin Anatomy (Cheatsheet)
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Liver Biopsy Procedure (Picmonic)
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Outline

Overview

  1. Biopsy
    1. Tissue removed
    2. Sent for testing/diagnosing

Nursing Points

General

  1. Procedure
    1. Sedation or numb site with lidocaine
    2. May use radiology guidance
    3. Needle inserted into tissue and removes piece
    4. Specimen sent to lab for testing
  2. Purpose -> diagnose
  3. Indications
    1. Suspicious lump
    2. Infection
    3. Inflammation
  4. Types
    1. Needle (fluid and tissue)
    2. Excisional (entire tumor removed)
    3. Incisional (part of tumor removed)
    4. Endoscopic (lungs, GI tract)

Assessment

  1. Before
    1. Explain procedure
    2. Consent
    3. Prepare lidocaine or sedation

Therapeutic Management

  1. During
    1. Time out
    2. Take precautions if radiology used
    3. Hand doctor supplies as needed
  2. After
    1. Bandage on site (if external)
    2. Take biopsy specimen to lab
    3. Assess site for bleeding

Nursing Concepts

  1. Patient-Centered Care –> biopsy location depends on patient’s diagnosis/symptoms
  2. Tissue/skin Integrity –> biopsy removes tissue from body

Patient Education

  1. Notify nurse of any bleeding or redness at site
  2. Doctor will provide results when they come back

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Transcript

Hey guys! Welcome to the lesson on biopsies!

Biopsies are used to diagnose disease in tissue or fluid. During the procedure, the site is numbed usually with lidocaine and the patient may be sedated. Radiology guidance may be needed like in this picture of a lung biopsy where the needle is then inserted and the tissue is removed. The specimen is then sent to lab for testing. 

The doctor might order a biopsy if the patient has a suspicious lump, infection, or inflammation. This may be inside or outside of the body. Next let’s discuss the different types of biopsies. 

There are different types of biopsies that may be done to obtain the specimen. Needle biopsies may be for aspiration of fluid. A core needle biopsy also known as punch biopsy like in this picture is where the tissue is taken in this device for testing. During excisional biopsies, the entire lump or tumor is removed. During incisional biopsies, just a part of the lump or tumor is removed for testing. Endoscopic biopsies are done in the body like in the lungs or GI tract with a camera for guidance. Let’s explore what the nurse role is in the biopsy. 

If a biopsy is ordered for your patient, you will explain the procedure to the patient and have them sign a consent. Ask the surgeon or doctor what supplies they need so that you may prepare them. 

So right before the procedure starts, a time out should be done to make sure it is the correct patient, procedure, and site. If the biopsy is guided by X-ray, radiation precautions need to be implemented to protect you and the patient. This means covering areas of the body that don’t need to be exposed to the radiation. You will hand the doctor supplies as they need them. 

After the procedure, bandage the site. Take the specimen to lab. Assess the site for bleeding or redness. 

The priority nursing concepts for the patient with a biopsy are patient-centered care and tissue/skin integrity. 

Alright guys, let’s review the key points about biopsies. A biopsy is where tissue is removed for testing and diagnosing disease in a patient. The doctor might order a biopsy in a patient if they have a suspicious lump, inflammation, or infection in tissue. Before the procedure, explain it to the patient and have them sign a consent. Obtain and prepare the supplies for the doctor. Right before beginning, a time out needs to be done to make sure it is the right patient, procedure, and site. If guided by X-ray, use radiation precautions to protect you and the patient. Provide supplies to the doctor as needed. After the procedure, cover the site and take the specimen to lab. Assess the site for redness and bleeding. 

Okay guys, that’s it on biopsies! Now go out and be your best self today, and as always, happy nursing!




 

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Concepts Covered:

  • Documentation and Communication
  • Legal and Ethical Issues
  • Medication Administration
  • Communication
  • Postoperative Nursing
  • Intraoperative Nursing
  • Preoperative Nursing
  • Vascular Disorders
  • Oncology Disorders
  • Musculoskeletal Trauma
  • Neurological Emergencies
  • Cardiac Disorders
  • Respiratory Disorders
  • Renal Disorders
  • Noninfectious Respiratory Disorder
  • Labor Complications
  • Eating Disorders
  • Disorders of Pancreas
  • Substance Abuse Disorders
  • Hematologic Disorders
  • Pregnancy Risks

Study Plan Lessons

How to Write A Nursing Progress Note
Documenting Escalation (Chain of Command)
Medication Errors
Legalities of Charting
Introduction to the Electronic Medical Record (EMR)
Provider Phone Calls
Shift change and Patient handoff
Daily Charting
Documentation Course Introduction
Post-Anesthesia Recovery
Postoperative (Postop) Complications
Discharge (DC) Teaching After Surgery
Local Anesthesia
Moderate Sedation
Malignant Hyperthermia
Preoperative (Preop)Assessment
Preoperative (Preop) Education
Preoperative (Preop) Nursing Priorities
General Anesthesia
Ultrasound
Biopsy
Informed Consent
Magnetic Resonance Imaging (MRI)
Cerebral Angiography
Cardiovascular Angiography
Echocardiogram (Cardiac Echo)
X-Ray (Xray)
Computed Tomography (CT)
ABGs Nursing Normal Lab Values
Metabolic Acidosis (interpretation and nursing diagnosis)
Respiratory Alkalosis
Respiratory Acidosis (interpretation and nursing interventions)
ABG (Arterial Blood Gas) Interpretation-The Basics
Isotonic Solutions (IV solutions)
Base Excess & Deficit
Metabolic Alkalosis
Sodium-Na (Hypernatremia, Hyponatremia)
Potassium-K (Hyperkalemia, Hypokalemia)
Hypertonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Hemoglobin (Hbg) Lab Values
Red Blood Cell (RBC) Lab Values
Platelets (PLT) Lab Values
White Blood Cell (WBC) Lab Values
Hematocrit (Hct) Lab Values
Ammonia (NH3) Lab Values
Cholesterol (Chol) Lab Values
Albumin Lab Values
Coagulation Studies (PT, PTT, INR)
Urinalysis (UA)
Creatinine (Cr) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Hemoglobin A1c (HbA1C)
Glucose Lab Values