Contraindication of liver biopsy is:?

AIIMS Delhi NO- 2019

Medical & Surgical Nursing

Medium

Appeared in: AIIMS Delhi NO- 2019

Explanation

The liver is a highly vascular organ, which makes hemorrhage the most significant risk associated with a biopsy.
An Increased Activated Partial Thromboplastin Time (aPTT) signifies that blood takes longer than normal to clot.
This impaired clotting ability, or coagulopathy, is a major contraindication because it dramatically increases the risk of severe, uncontrolled bleeding during and after the procedure.

Option A: Diabetes is a comorbidity that requires management (e.g., blood glucose monitoring), but it does not directly increase the risk of hemorrhage from the biopsy itself and is therefore not a contraindication.
Option B: A decreased aPTT indicates a hypercoagulable state (blood clots too quickly). The primary risk of a liver biopsy is bleeding, not clotting, so this is not a contraindication.
Option D: An immunocompromised state increases the risk of post-procedure infection, not bleeding. While it necessitates strict aseptic technique, it is not an absolute contraindication.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Contraindications for Liver Biopsy as background academic context rather than a clinical decision trigger.
A key nursing responsibility is to review pre-procedure lab results and immediately notify the provider of any abnormalities in coagulation studies (aPTT, PT/INR, platelet count) before the patient is taken for the biopsy.
Post-procedure, the nurse's priority is vigilant monitoring for signs of internal hemorrhage, which include tachycardia, hypotension, restlessness, pallor, and increasing abdominal pain or girth.
What if? If a patient has severe coagulopathy but a biopsy is absolutely essential, the provider may opt for a transjugular liver biopsy. This approach accesses the liver through the jugular vein, which contains bleeding within the vascular system, significantly reducing the risk of intra-abdominal hemorrhage.

How to Approach the Question

First, identify the core procedure mentioned in the question: a liver biopsy.
Recall the key anatomical and physiological characteristic of the organ involved. The liver is highly vascular.
Deduce the primary and most dangerous complication of puncturing a highly vascular organ: bleeding (hemorrhage).
Evaluate each option based on how it relates to this primary risk of bleeding.
An 'increased' or 'prolonged' clotting time directly translates to a higher risk of bleeding, making it a logical contraindication.
Consider the other options: diabetes, decreased clotting time (hypercoagulability), and a weak immune system do not directly increase the risk of hemorrhage from the procedure itself.

Concept Tested & Keywords

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