A client after liver biopsy should be vigilantly observed for?

SCTIMST Staff Nurse - 2015 (Set-A)

Medical & Surgical Nursing

Easy

Appeared in: SCTIMST Staff Nurse - 2015 (Set-A)

Explanation

The liver is a highly vascular organ, making hemorrhage (bleeding) the most significant and life-threatening immediate complication following a biopsy.
Signs of hemorrhage include tachycardia (rapid heart rate), hypotension (low blood pressure), pallor, abdominal distension, and severe or radiating pain (e.g., to the right shoulder).
Vigilant monitoring of vital signs and the biopsy site is crucial for early detection of bleeding.
Nursing interventions, such as positioning the patient on their right side, apply pressure to the site to help control potential bleeding.

Option B: Dyspnoea (shortness of breath) is not the primary complication. While possible, it is less common and usually indicates a pneumothorax, which can occur if the biopsy needle punctures the lung.
Option C: Vomiting is a non-specific symptom and not a direct or common complication of a liver biopsy. It does not indicate the most life-threatening risk.
Option D: Some degree of pain at the biopsy site is expected and normal. While severe or worsening pain can be a symptom of hemorrhage, pain itself is not the primary complication to be monitored.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Post-procedure complications of liver biopsy as background academic context rather than a clinical decision trigger.
The nurse's primary role after a liver biopsy is the early detection of hemorrhage, which can rapidly progress to hypovolemic shock if not identified and treated promptly.
Positioning the patient on their right side is a simple yet critical nursing intervention that uses the body's own weight to apply pressure (tamponade) to the liver biopsy site, reducing the risk of bleeding.
What if? The patient complains of new-onset right shoulder tip pain 2 hours after the biopsy. This is a critical finding (Kehr's sign) that suggests diaphragmatic irritation from intra-abdominal bleeding and requires immediate notification of the healthcare provider.

How to Approach the Question

First, identify the core procedure in the question: a liver biopsy.
Next, recall the anatomy and physiology of the organ involved. The liver is highly vascular, meaning it has a large blood supply.
Consider the nature of the procedure—a needle is inserted into this vascular organ. This immediately points to bleeding as a major risk.
Evaluate the options based on this primary risk. Haemorrhage is a direct and life-threatening possibility.
Analyze the other options: Dyspnoea, vomiting, and pain are either less common complications or expected side effects/symptoms, not the primary life-threatening complication itself.
Conclude that monitoring for hemorrhage is the most critical priority.

Concept Tested & Keywords

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