Biopsy

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Study Tools For Biopsy

Skin Anatomy (Cheatsheet)
Types of Skin Cancer (Cheatsheet)
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:

  • Respiratory Disorders
  • EENT Disorders
  • Prenatal Concepts
  • Acute & Chronic Renal Disorders
  • Disorders of the Adrenal Gland
  • Integumentary Disorders
  • Oncology Disorders
  • Preoperative Nursing
  • Musculoskeletal Trauma
  • Disorders of the Posterior Pituitary Gland
  • Hematologic Disorders
  • Renal Disorders
  • Labor Complications
  • Immunological Disorders
  • Upper GI Disorders
  • Neurological Emergencies
  • Disorders of Pancreas
  • Musculoskeletal Disorders
  • Cardiac Disorders
  • Disorders of the Thyroid & Parathyroid Glands
  • Integumentary Important Points
  • Pregnancy Risks
  • Noninfectious Respiratory Disorder
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  • Liver & Gallbladder Disorders
  • Central Nervous System Disorders – Spinal Cord
  • Emergency Care of the Cardiac Patient
  • Peripheral Nervous System Disorders
  • Substance Abuse Disorders
  • Female Reproductive Disorders
  • Postpartum Complications
  • Fetal Development
  • Shock
  • Emergency Care of the Neurological Patient
  • Labor and Delivery
  • Postpartum Care
  • Newborn Care
  • Newborn Complications

Study Plan Lessons

ABGs Nursing Normal Lab Values
Glaucoma
Menstrual Cycle
X-Ray (Xray)
ABG (Arterial Blood Gas) Interpretation-The Basics
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Addisons Disease
Burn Injuries
Cataracts
Computed Tomography (CT)
Family Planning & Contraception
Informed Consent
Nursing Care and Pathophysiology for Cushings Syndrome
Macular Degeneration
Magnetic Resonance Imaging (MRI)
Preoperative (Preop)Assessment
Pressure Ulcers/Pressure injuries (Braden scale)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Isotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology for Pancreatitis
Preoperative (Preop) Education
Cerebral Angiography
Hearing Loss
Hypotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Preoperative (Preop) Nursing Priorities
Respiratory Acidosis (interpretation and nursing interventions)
Thrombocytopenia
Blood Transfusions (Administration)
Cardiovascular Angiography
Fractures
Nursing Care and Pathophysiology for Hyperthyroidism
Hypertonic Solutions (IV solutions)
Integumentary (Skin) Important Points
Preload and Afterload
Respiratory Alkalosis
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Echocardiogram (Cardiac Echo)
Nursing Care and Pathophysiology for Hypothyroidism
Metabolic Acidosis (interpretation and nursing diagnosis)
Performing Cardiac (Heart) Monitoring
Metabolic Alkalosis
Ultrasound
Base Excess & Deficit
Biopsy
Gestation & Nägele’s Rule: Estimating Due Dates
Potassium-K (Hyperkalemia, Hypokalemia)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
General Anesthesia
Gravidity and Parity (G&Ps, GTPAL)
Leukemia
Levels of Consciousness (LOC)
Sodium-Na (Hypernatremia, Hyponatremia)
Diabetes Management
Dialysis & Other Renal Points
Local Anesthesia
Lymphoma
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Routine Neuro Assessments
Adjunct Neuro Assessments
Chloride-Cl (Hyperchloremia, Hypochloremia)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Fundal Height Assessment for Nurses
Moderate Sedation
Oncology Important Points
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Malignant Hyperthermia
Maternal Risk Factors
Intracranial Pressure ICP
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Cerebral Perfusion Pressure CPP
Nursing Care and Pathophysiology for Crohn’s Disease
Normal Sinus Rhythm
Physiological Changes
Post-Anesthesia Recovery
Red Blood Cell (RBC) Lab Values
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Cholecystitis
Discomforts of Pregnancy
Nursing Care and Pathophysiology for Heart Failure (CHF)
Hemoglobin (Hbg) Lab Values
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Postoperative (Postop) Complications
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Antepartum Testing
Hematocrit (Hct) Lab Values
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Sinus Tachycardia
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Discharge (DC) Teaching After Surgery
Nutrition in Pregnancy
Pacemakers
White Blood Cell (WBC) Lab Values
Atrial Fibrillation (A Fib)
Platelets (PLT) Lab Values
Coagulation Studies (PT, PTT, INR)
Miscellaneous Nerve Disorders
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Albumin Lab Values
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Cholesterol (Chol) Lab Values
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of Hypertension (HTN)
Ammonia (NH3) Lab Values
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Chorioamnionitis
Nursing Care and Pathophysiology for Menopause
Stroke Assessment (CVA)
Nursing Care and Pathophysiology for Cardiomyopathy
Gestational Diabetes (GDM)
Stroke Therapeutic Management (CVA)
Disseminated Intravascular Coagulation (DIC)
Stroke Nursing Care (CVA)
Ectopic Pregnancy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Blood Urea Nitrogen (BUN) Lab Values
Creatinine (Cr) Lab Values
Fetal Development
Nursing Care and Pathophysiology for Hypovolemic Shock
Seizure Causes (Epilepsy, Generalized)
Nursing Care and Pathophysiology for Cardiogenic Shock
Fetal Environment
Seizure Assessment
Nursing Care and Pathophysiology for Distributive Shock
Fetal Circulation
Seizure Therapeutic Management
Urinalysis (UA)
Nursing Care and Pathophysiology for Seizure
Glucose Lab Values
Process of Labor
Hemoglobin A1c (HbA1C)
Mechanisms of Labor
Leopold Maneuvers
Fetal Heart Monitoring (FHM)
Nursing Care and Pathophysiology for Meningitis
Prolapsed Umbilical Cord
Placenta Previa
Abruptio Placentae (Placental abruption)
Preterm Labor
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Postpartum Discomforts
Breastfeeding
Postpartum Hemorrhage (PPH)
Mastitis
Initial Care of the Newborn (APGAR)
Newborn Physical Exam
Body System Assessments
Newborn Reflexes
Babies by Term
Meconium Aspiration
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Newborn of HIV+ Mother
Hemodynamics
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)