ATI Content Mastery RN Adult Medical
Surgical Nursing Unit 5
Hematologic diagnostic procedures: blood collection - ANS hematologic diagnostic procedures
of blood components that nurses should be knowledgeable about:
RBC count
WBC count
mean corpuscular volume
mean corpuscular Hgb
total iron-binding count
iron
platelets
Hgb
Hct
coagulation studies
-prothrombin time
-partial prothrombin time
-international normalized ratio
-D-dimer
fibrinogen levels
fibrin degradation products
Blood collection pre-procedure considerations - ANS use standard precautions in collecting and
handling blood for specimen collection
Blood collection intra-procedure considerations - ANS for coagulation studies, draw blood at
specific times and immediately send to the laboratory. Adjust the dose of anticoagulant therapy
based on the results and prescription
Blood collection post-procedure considerations - ANS results of hematologic tests are usually
available preliminary within 24 to 48 hours, with final results in 72 hours
if results are out of the expected reference range, it is the nurse's responsibility to report the
results to the provider for further intervention
Hematologic diagnostic procedures: bone marrow biopsy - ANS a biopsy is the extraction of a
very small amount of tissue, such as bone marrow, to definitively diagnose cell type and to
confirm or rule out malignancy
biopsies are commonly performed with local anesthesia or conscious sedation in an ambulatory
setting, intraoperatively, or during endoscopic procedures
, Bone marrow biopsy indications - ANS to diagnose the cause of blood disorders
to diagnose diseases of the bone marrow
to stage forms of cancer
Bone marrow biopsy considerations pre-procedure - ANS ensure that the client has provided
informed consent
place the client in a prone or side lying position to expose the iliac crest for the procedure
explain the procedure to the client
the biopsy site will be anesthetized with a local anesthetic, and there can be a feeling of
pressure and brief pain during the aspiration
there will be a sensation of pressure as the biopsy needle is inserted, and a crunching sound
might be heard when the needle enters the bone
Bone marrow biopsy considerations intra-procedure - ANS administer a sedative if prescribed
-older adult clients are at greater risk for complications associated with sedation for biopsy
procedures due to chronic illness
-the nurse should take an older adult's kidney function into consideration when using analgesics
for sedation
cleanse the site with an antiseptic solution
maintain sterility of equipment and supplies
assist the provider with the procedure as needed
the test will last about 20 minutes
Bone marrow biopsy considerations post-procedure - ANS apply pressure to the biopsy site to
control bleeding
place a sterile dressing over the biopsy site
maintain the client on bed rest for 30 to 60 minutes
monitor for manifestations of infection and bleeding
apply ice to the biopsy site to minimize bleeding and bruising
postprocedural discomfort is usually relieved by mild analgesics
avoid aspirin and other medications that affect clotting
report excessive bleeding and evidence of infection to the provider
check the biopsy site daily. keep the dressing clean, dry, and intact
if sutures are in place, return in 7 to 10 days to have them removed
Complications of bone marrow biopsy - ANS infection
nursing actions: monitor the site, and keep the dressing clean and dry
bleeding
nursing actions: report bleeding to the provider immediately; apply a pressure dressing over the
site
Elevated RBC indication - ANS erythrocytosis
polycythemia vera
severe dehydration
Surgical Nursing Unit 5
Hematologic diagnostic procedures: blood collection - ANS hematologic diagnostic procedures
of blood components that nurses should be knowledgeable about:
RBC count
WBC count
mean corpuscular volume
mean corpuscular Hgb
total iron-binding count
iron
platelets
Hgb
Hct
coagulation studies
-prothrombin time
-partial prothrombin time
-international normalized ratio
-D-dimer
fibrinogen levels
fibrin degradation products
Blood collection pre-procedure considerations - ANS use standard precautions in collecting and
handling blood for specimen collection
Blood collection intra-procedure considerations - ANS for coagulation studies, draw blood at
specific times and immediately send to the laboratory. Adjust the dose of anticoagulant therapy
based on the results and prescription
Blood collection post-procedure considerations - ANS results of hematologic tests are usually
available preliminary within 24 to 48 hours, with final results in 72 hours
if results are out of the expected reference range, it is the nurse's responsibility to report the
results to the provider for further intervention
Hematologic diagnostic procedures: bone marrow biopsy - ANS a biopsy is the extraction of a
very small amount of tissue, such as bone marrow, to definitively diagnose cell type and to
confirm or rule out malignancy
biopsies are commonly performed with local anesthesia or conscious sedation in an ambulatory
setting, intraoperatively, or during endoscopic procedures
, Bone marrow biopsy indications - ANS to diagnose the cause of blood disorders
to diagnose diseases of the bone marrow
to stage forms of cancer
Bone marrow biopsy considerations pre-procedure - ANS ensure that the client has provided
informed consent
place the client in a prone or side lying position to expose the iliac crest for the procedure
explain the procedure to the client
the biopsy site will be anesthetized with a local anesthetic, and there can be a feeling of
pressure and brief pain during the aspiration
there will be a sensation of pressure as the biopsy needle is inserted, and a crunching sound
might be heard when the needle enters the bone
Bone marrow biopsy considerations intra-procedure - ANS administer a sedative if prescribed
-older adult clients are at greater risk for complications associated with sedation for biopsy
procedures due to chronic illness
-the nurse should take an older adult's kidney function into consideration when using analgesics
for sedation
cleanse the site with an antiseptic solution
maintain sterility of equipment and supplies
assist the provider with the procedure as needed
the test will last about 20 minutes
Bone marrow biopsy considerations post-procedure - ANS apply pressure to the biopsy site to
control bleeding
place a sterile dressing over the biopsy site
maintain the client on bed rest for 30 to 60 minutes
monitor for manifestations of infection and bleeding
apply ice to the biopsy site to minimize bleeding and bruising
postprocedural discomfort is usually relieved by mild analgesics
avoid aspirin and other medications that affect clotting
report excessive bleeding and evidence of infection to the provider
check the biopsy site daily. keep the dressing clean, dry, and intact
if sutures are in place, return in 7 to 10 days to have them removed
Complications of bone marrow biopsy - ANS infection
nursing actions: monitor the site, and keep the dressing clean and dry
bleeding
nursing actions: report bleeding to the provider immediately; apply a pressure dressing over the
site
Elevated RBC indication - ANS erythrocytosis
polycythemia vera
severe dehydration
