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Ateneo de Zamboanga University College of Nursing Nursing Skills Output (NSO) Biopsies Report no.

Description: it is a procedure done by extracting severed tissue for diagnosis. Materials/ Equipment Needed:
Clean gloves Anesthesia (if its a surgical biopsy) Medication (anti anxiety) Sterile eye dressing (pad), as needed, and paper eye tape to secure it

Procedures: Prepare the site where the biopsy is to be done and the patient. Depending on the site, instruct the patient to be in a position comfortable for the medical practitioner to do the biopsy. Administer anesthesia. Patient may also be given an anti anxiety to relax. For surgical biopsies, the anesthesiologist may administer general anesthesia.

Assist with the procedure. There are various kinds of biopsy procedure, including: Bone marrow biopsy - a small sample of bone marrow (usually from the hip) is removed via a slender needle. This type of biopsy helps to diagnose diseases such as leukaemia. Colposcopy-directed biopsy - a colposcope is a small microscope used to examine a womans cervix while a tissue sample is taken. This biopsy is usually performed to investigate the reasons for an abnormal Pap test result. Endoscopic biopsy - the endoscope is a flexible tube that can be inserted into an orifice (such as the mouth or anus) or through a small skin incision. Once the lump is reached, cutting tools are threaded through the endoscope so that a sample of tissue can be taken. Excisional biopsy - the lump is entirely removed. Depending on the location of the lump, the patient may need to undergo general anaesthesia. This type of biopsy may be used for breast lumps.

September 12-14, 2011 Date

Que, Honey Sharlotte

Clinical Instructors Initials

Incisional biopsy - only a small slice of the lump is removed. Depending on the location of the lump, a general or local anaesthetic may be needed. This type of biopsy may be used for lumps located in connective tissue such as muscle.

Needle biopsy - a small sample of the lump is removed via a slender hypodermic needle. This can be done either with or without local anaesthetic. This type of biopsy may be used to diagnose conditions of the liver or thyroid. Punch biopsy - a special tool is used to punch a hole through the uppermost layers of the skin. The anaesthetic used may be local or topical. This type of biopsy can help diagnose various skin conditions. Stereotactic biopsy - a series of x-rays help to guide the surgeons needle to the lump. This type of biopsy is usually performed whenever the lump is hard to see or feel. A large needle is inserted into the area of interest and used to remove a sample from a conscious patient. If the area being biopsied is on the skin, a scalpel will be used to scrape off a sample.

The biopsy may be taken with the assistance of medical imaging such as ultrasound. The medical imaging is used to correctly identify the area of interest so that the sample is taken from the right place.

In a wire-guided biopsy, the imaging is used while fine wires are placed to mark the area which needs to be biopsied, and a surgeon uses the wires as a guide for a surgical biopsy. Some procedures may require the use of endoscopic probes which are inserted into the body to generate an image, allowing the doctor to clearly see the site which needs to be biopsied. In the case of a surgical biopsy, the surgeon will close the site and bandage it, providing the patient with aftercare instructions. Needle biopsies and surface biopsies may ooze slightly, so they are usually covered with light bandages, and the patient may be asked to be careful around the site while it heals. Assess clients response.

September 12-14, 2011 Date

Que, Honey Sharlotte Illustration/diagram

Clinical Instructors Initials

September 12-14, 2011 Date

Que, Honey Sharlotte

Clinical Instructors Initia

NURSING RESPONSIBILITIES Before Procedure: Before the procedure, you need to discuss a range of issues with your doctor or surgeon including:

Medical history, including any prescription drugs, over-the-counter drugs, herbs, vitamin or mineral supplements you may be taking. Some preparations can interact with surgical medications and need to be avoided. Other tests, such as blood tests or ultrasound scans, may need to be done prior to the biopsy (depending on the nature of the condition under investigation). Clean the area where the biopsy is supposed to be done. If hair is present, shave it off. Inform the patient that he/she will experience discomfort during the procedure. Instruct the patient to stay completely still during the procedure, if conscious.

During Procedure: Assist with the procedure. Monitor the patient, if unconscious.

After Procedure:

Inform the patient that it will be normal for him/her to feel some pain around the biopsy site. This should resolve, or at least ease over the next two or three days. Monitor the patient and check for bleeding on site of biopsy. Document all relevant assessments and interventions.

September 12-14, 2011 Date

Que, Honey Sharlotte

Clinical Instructors Initials