Neoplasms Lecture Diagnostic Tests

Question 1

Bronchoscopy Purpose

Answer 1

Allows direct visulization of the tracheobronchial tree for abnormalities. Permits biopsy from observed lesions. Also used for the removal of foreign bodies and aspiration of deep sputum for culture and sensitivity

Question 2

Diagnostic Test

Answer 2

Tests performed to determine tissue type of malignancy, primary site of malignancy, and the extent of the disease within the body. Results of these tests help to determine the therapeutic regimen

Question 3

Bronchoscopy Procedure

Answer 3

• Lighted, flexible fiberoptic tube is passed through the mouth into the tracheobronchial tree
• Patient’s nasopharynx and oropharynx are anesthetized topically with lidocaine spray before the insertion of the scope
• Atropine to dry respiratory secretions and midazolam for conscious sedation are usually provided prior to the exam

Question 4

Bronchoscopy Nursing Interventions

Answer 4

• Informed consent required
• NPO 6-12 hours prior to test
• Remove denture and provide mouth care prior to test. may receive antiseptic rinse evening before and day or test
• Maintain NPO status and semi-fowler’s position (may turn side to side) until gag reflex returns
• Monitor for signs and symptoms laryngeal edema and spasm (progressive dyspnea and stridor). If biopsy taken, monitor for bleeding a pneumothorax
• Expect small amounts pink tinged mucous only

Question 5

Ultrasound Purpose

Answer 5

Measures and records high frequency sound waves as they pass through tissues of variable density. useful in distinguishing cystic from solid masses. ineffective in detecting small nonpalpable cancers or distinguishing between benign or malignant solid tumors

Question 6

Ultrasound Procedure

Answer 6

• Trasducer is guided over the area and images are observed on an oscilloscope.
• Greasy, conductive paste is applied to the desired area
• Images obtained:
  
  • Transvaginally: lubricated transducer inserted a few cm. into vagina with patient in lithtomy position to evaluate reproductive organs
  • Transrectally: lubricated transducer inserted within the rectum with patient in the left lateral position (evaluate prostate)

Question 7

Ultrasound Nursing Interventions

Answer 7

• Require a full bladder to allow for visulization. Instruct client to drink 350 mL of water one hour prior to exam. Client should not void 2 hours prior to exam. client may void immediately after the exam
• Breast Ultrasounds: client should avoid use of lotion on breast which could interfere with test
• Transrectal ultrasounds: client should use a small volume rectal enema one hour prior to exam to allow for greater visulization in the area

Question 8

Biopsy Purpose

Answer 8

Removal of tissue from an organ or other body part for microscopic examination. Determine if the tissue is benign or malignant and the degree of differentiation of the cell. Biopsy is the definitive test for diagnosing cancer. Excisional biopsy allows for the complete removal of the tumor and is considered therapeutic as well as diagnostic

Question 9

Biopsy Procedure

Answer 9

• Open biopsy
  
  • excisional and incisional procedures. may require general anesthesia as an outpatient procedure
• Closed biopsy
  
  • cutting needle, sterotactic core biopsy or fine needle aspiration
  • local anesthetic usually sufficient

Question 10

Biopsy Nursing Interventions

Answer 10

• informed consent required
• specific interventions depend upon the type and location of the biopsy
• to reduce the high levels of anxiety and stress associated with a biopsy, teach client about preparation for the biopsy, sensations to expect during procedure, postprocedure routines, and care of the biopsy site
• with all procedures the risk for bleeding and infection is present
• Assess the site and teach patient signs and symptoms and course of action for infection/bleeding prior to discharge