⚠️ Reduction of Risk · Lesson 3 of 6 · 8 min

Procedure Prep and Aftercare: The Questions You Will Get

🩻 Lie flat after the lumbar puncture. Lie on the right side after the liver biopsy. Sit up and lean forward during the thoracentesis. The exam will give you one procedure and four positions.

💡 Key idea

Cath: pulses, site, straight leg, fluids. Scopes: NPO until the gag returns. Thoracentesis: sit forward, still. Paracentesis: void first. LP: lie flat. Liver biopsy: right side.

🧠 Why it matters

CARDIAC CATHETERIZATION: ask about any prior reaction to iodinated contrast (a shellfish allergy alone is not a reason to avoid contrast) and about kidney function, hold metformin around the procedure, keep NPO as ordered; afterward check the insertion site for bleeding or hematoma, compare distal pulses, color and temperature, keep the extremity straight for the ordered hours, and push fluids to clear the dye. BRONCHOSCOPY and ENDOSCOPY: NPO before and until the gag reflex returns afterward. THORACENTESIS: sit upright leaning forward on an overbed table, do not cough or move during needle insertion; afterward watch for pneumothorax (sudden dyspnea, absent breath sounds) and expect a chest X-ray. PARACENTESIS: void immediately before to avoid bladder puncture, measure weight and abdominal girth, watch for hypovolemia after large-volume removal. LUMBAR PUNCTURE: side-lying with knees drawn up; afterward lie flat as ordered, encourage fluids, and report severe headache or leakage. LIVER BIOPSY: check coagulation studies first, have the client exhale and hold during insertion, then lie on the RIGHT side for about 2 hours to compress the site and watch for bleeding. EEG: wash the hair, no caffeine, no sedatives, and do not skip meals. MRI: screen for metal, implants and pacemakers. COLONOSCOPY: bowel prep and clear liquids the day before; afterward expect cramping and flatus, and report severe pain, fever or bleeding, which suggest perforation or hemorrhage. Before an ARTERIAL blood gas, perform the Allen test and apply firm pressure for 5 minutes afterward.

🏥 In the real world

🦵 After a femoral cardiac catheterization a client's right foot becomes pale and cool with a weak pedal pulse compared with the left. The nurse checks the site (no bleeding) and calls the provider immediately: a clot or spasm is blocking the artery used for the catheter. Distal pulse checks after this procedure are not routine paperwork; they catch limb-threatening ischemia.

📌 Takeaways

After cardiac cath: site, pulses, leg straight, fluids; metformin held
No food until the gag reflex returns after bronchoscopy or endoscopy
Thoracentesis: sit forward; paracentesis: void; LP: flat; liver biopsy: right side

✅ Test yourself

A client returns from a bronchoscopy and asks for a drink of water. What should the nurse do first?

Check for the return of the gag reflex
Provide the water
Offer ice chips instead
Raise the head of the bed and provide a straw

Answer: A · Check for the return of the gag reflex

Local anesthesia suppresses the gag reflex; nothing is given by mouth until it returns.

How should the nurse position a client after a percutaneous liver biopsy?

High Fowler's
Prone with a pillow under the abdomen
On the right side for about 2 hours
On the left side with the head elevated

Answer: C · On the right side for about 2 hours

Lying on the right side compresses the liver against the chest wall to reduce bleeding at the biopsy site.

Which assessment is the priority in the first hours after a femoral cardiac catheterization?

Deep tendon reflexes
Distal pulses in the affected leg
Pupil response to light
Bowel sounds in all four quadrants

Answer: B · Distal pulses in the affected leg

Arterial access can lead to bleeding, hematoma or occlusion; neurovascular checks of the extremity detect them early.

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