Nurse should be alert for following complications after patient has undergone bronchoscopy:

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

Medical & Surgical Nursing

Hard

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

Explanation

Pneumothorax, or a collapsed lung, is a critical and potentially life-threatening complication of bronchoscopy.
It occurs if the pleura (the lining of the lung) is punctured by the bronchoscope or a biopsy instrument.
The classic signs are sudden onset of dyspnea (shortness of breath), unilateral chest pain, and diminished or absent breath sounds on the affected side.
Unlike some other complications, pneumothorax is never an expected finding and always constitutes a medical emergency requiring immediate intervention.

Option A: Bronchitis is an inflammation of the bronchial tubes. While it could theoretically occur from irritation or infection introduced during the procedure, it is not an immediate complication. Symptoms would develop over days.
Option B: While massive haemoptysis (coughing up large amounts of blood) is a serious complication, a small amount of blood-streaked sputum is common and expected, especially if a biopsy was performed. Therefore, haemoptysis itself is not as specific an indicator of a critical complication as pneumothorax.
Option C: Pneumonitis is inflammation of the lung tissue, often due to infection. Similar to bronchitis, this is a delayed complication that would manifest with fever and other signs of infection hours to days after the procedure, not in the immediate post-procedural period.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Post-procedural complications of bronchoscopy in the correct sequence, documenting the action clearly, and monitoring for the expected response.
A nurse's primary role in post-bronchoscopy care is vigilant monitoring for acute complications. Prompt identification of respiratory distress is key to patient safety.
The priority nursing assessment includes respiratory rate, oxygen saturation, breath sounds, and assessing for chest pain. Any sign of deterioration requires immediate escalation to the healthcare provider.
What if? If the patient had a transbronchial biopsy (a biopsy of the lung tissue itself), the risk for both pneumothorax and significant bleeding (haemoptysis) increases substantially, requiring even more vigilant monitoring.

How to Approach the Question

First, identify the core of the question: it asks for a complication of bronchoscopy that a nurse should be 'alert for'. This implies an acute, serious, and actionable finding.
Next, consider the timeline of each option. Bronchoscopy involves inserting a scope into the airways.
Evaluate each option based on its potential onset. Pneumothorax (lung puncture) and Haemoptysis (bleeding) are immediate risks. Bronchitis and Pneumonitis (infections) are delayed risks.
Differentiate between the immediate risks. While bleeding can occur, minor bleeding is often expected. A pneumothorax, however, is never expected and is always a critical emergency.
Conclude that the signs of pneumothorax represent the most critical and urgent complication the nurse must be alert for.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 pp. 463-465, 365-367