The nurse cares for a client scheduled for a percutaneous left kidney biopsy as an outpatient. Which intervention should the nurse include in the client's post-procedure care plan?

Question

The nurse cares for a client scheduled for a percutaneous left kidney biopsy as an outpatient.  Which intervention should the nurse include in the client's post-procedure care plan?

Quizplus · Accepted Answer

A kidney biopsy involves obtaining a tissue sample for pathological evaluation to determine the cause of certain kidney diseases (eg, nephritis, transplant rejection). The kidney has extensive vasculature (similar to the liver); therefore, bleeding from the biopsy site is the major complication following a percutaneous kidney biopsy. Before the procedure, the client must give informed consent and discontinue all anticoagulants (eg, heparin, warfarin, rivaroxaban) and antiplatelet agents (eg, aspirin, clopidogrel, nonsteroidal anti-inflammatory drugs) for at least one week. The client should be typed and crossmatched for blood (although the need for a transfusion is rare). Blood pressure should be well-controlled. After the procedure, the nurse should monitor vital signs at least every 15 minutes for the first hour as tachycardia, tachypnea, and hypotension can indicate blood loss. The nurse should also assess the puncture site dressing for bleeding (Option D). (Option A) Blood urea nitrogen (BUN) and creatinine levels would not change significantly within 30-60 minutes. These are usually measured once every 24 hours and rarely every 12 hours. (Option B) Insertion of an indwelling urinary catheter is not necessary to perform a kidney biopsy and is not part of the usual protocol. (Option C) Post-procedure, the client should be positioned on the affected (left) side for 30-60 minutes to provide pressure and help prevent bleeding. The client is usually placed in the prone position during the procedure to facilitate access to the kidney. Educational objective: Bleeding is a complication following a kidney biopsy. For assessment and prevention of this complication the nurse should monitor vital signs frequently, assess the biopsy site and dressing, and have the client positioned on the affected side for 30-60 minutes and on bed rest for 24 hours.

The Nurse Cares for a Client Scheduled for a Percutaneous