liver biopsy, a diagnostic procedure in which a special needle is introduced into the liver under local anesthesia to obtain a specimen for pathological examination. ▪ METHOD: Before a liver biopsy is performed by a physician, the procedure is explained to the patient, whose baseline vital signs are recorded and who is taught how to inhale and hold the breath during needle insertion. After the patient’s possible allergy to the local anesthetic is checked and results of bleeding, clotting, and prothrombin tests are obtained, an analgesic or sedative is administered as ordered. The biopsy is performed with ultrasound visualization. On completion of the biopsy, pressure is applied to the site for 15 minutes. The patient is positioned on the right side for the first 2 hours and remains in a supine position in bed for the next 22 hours. The blood pressure, pulse, and respirations are checked every 15 minutes for the first hour, then every 30 minutes for the next 2 hours, and subsequently every 4 hours or as ordered. The biopsy site is observed every 30 minutes for bleeding, swelling, or increased pain; epigastric or referred shoulder pain may occur. Analgesia and vitamin K are given as ordered, and the recumbent patient is assisted with eating and other activities as needed. A postbiopsy complete blood count is performed. ▪ INTERVENTIONS: The health care provider reinforces explanations of the biopsy and its purpose, provides care before and after the procedure, and closely observes the patient for postbiopsy complications such as intraperitoneal hemorrhage, shock, and pneumothorax. ▪ OUTCOME CRITERIA: An uneventful liver biopsy is a valuable aid in establishing a diagnosis of hepatic disease, including primary and metastatic malignant neoplastic disease.
