After liver biopsy which complication should be monitored?

PGIMER NO - 2020

Medical & Surgical Nursing

Easy

Appeared in: PGIMER NO - 2020

Explanation

The liver is a highly vascular organ, receiving approximately 25% of the cardiac output, which makes it prone to bleeding after being punctured.
Hemorrhage is the most common and life-threatening early complication following a percutaneous liver biopsy.
Post-procedure nursing care prioritizes the early detection of bleeding through frequent monitoring of vital signs (tachycardia, hypotension), assessing for abdominal pain or distension, and checking the puncture site.
Positioning the patient on their right side immediately after the procedure helps apply pressure to the biopsy site to control bleeding.

Option B: Infection is a potential but less common complication of a liver biopsy. Its onset is typically delayed, appearing 24-72 hours after the procedure, whereas hemorrhage is an immediate risk.
Option C: A pulmonary embolism is not a direct complication of the liver biopsy procedure itself. It involves a blood clot traveling to the lungs.
Option D: The primary risk from puncturing the liver is uncontrolled bleeding (hemorrhage), not the formation of blood clots (thrombosis) at the site.

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 vigilant monitoring for hemorrhage. Early detection of tachycardia and hypotension is critical for timely intervention and preventing hypovolemic shock.
A key nursing intervention is positioning the patient on their right side for 1-2 hours post-procedure. This uses the patient's own body weight to apply pressure to the liver's capsule at the biopsy site, acting as a natural pressure dressing to prevent bleeding.
What if? If the patient's pre-procedure platelet count was less than 80,000/μL or their prothrombin time was significantly prolonged, the risk of hemorrhage would be unacceptably high. The percutaneous procedure would likely be cancelled or an alternative approach, such as a transjugular liver biopsy, would be considered to minimize bleeding risk.

How to Approach the Question

First, identify the core of the question: it asks for the most important complication to monitor after a specific procedure (liver biopsy).
Analyze the procedure itself. A liver biopsy involves puncturing a large, solid, and highly vascular organ.
Consider the immediate, direct consequences of this action. Puncturing blood vessels creates a high risk of bleeding.
Evaluate the given options in the context of this primary risk. Hemorrhage is a direct and immediate consequence.
Compare this to other options. Infection is a later complication. Pulmonary emboli and blood clots are indirect risks related to general patient status (like immobility), not the specific action of puncturing the liver.
Conclude that hemorrhage is the most immediate and life-threatening complication that requires priority monitoring.

Concept Tested & Keywords

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