Medical Surgical Bronchoscopy #3

Question

The nurse is caring for a conscious client post-bronchoscopy procedure. Which interventions are indicated by the nurse? Select all that apply.

Answers

  1. Assess for the return of the gag reflex.
    • Rationale:

      This answer is correct because the gag reflex is a reflexive action to prevent choking or swallowing something harmful. Since the throat has been numbed from the anesthetic, there is a higher risk for this. Assessing for the return of the gag reflex will prevent the client from choking or aspiration before eating.

  2. Maintain NPO until gag reflex returns.
    • Rationale:

      This answer is correct because until the client the gag reflex return, NPO status should be maintained. The throat is paralyzed from the anesthetic, therefore the client is at risk for choking. Once the gag reflex has been established, the client can resume meals.

  3. Monitor for bloody sputum.
    • Rationale:

      This answer is correct because excessive bleeding indicates a complication and should be reported to the provider. Also, the client could aspirate on the blood. A minimal amount of blood is expected for a few hours after the procedure.

  4. Encourage the client to spit in the basin instead of swallow.
    • Rationale:

      This answer is correct because it prevents the client from aspiration. Also, by spitting into the basin, the nurse also monitors for blood in the sputum. A minimal amount of blood is expected; however, excessive bleeding should be reported.

  5. Position client on the side with head of bed slightly raised.
    • Rationale:

      This answer is not correct because the client is conscious. Positioning the client on the side with the head of bed slightly raised is the positioning required for an unconscious client. If the client is conscious, the semi-Fowler’s position is indicated.

Overview

A bronchoscopy procedure involves inserting the respiratory tract with a fiberoptic scope for direct visual examination of the larynx, trachea, and bronchi. Postprocedure interventions are concomitant with maintaining airway patency, preventing aspiration or choking, and assessing for complications.

Explanation

Learning Outcomes

A bronchoscopy procedure involves inserting the respiratory tract with a fiberoptic scope for direct visual examination of the larynx, trachea, and bronchi. Interventions post procedure include assessing for the return of the gag reflex, maintaining NPO status until gag reflex returns, monitoring for bloody sputum, encouraging the client to spit in the emesis basin, instead of swallowing, positioning the conscious client in the semi-Fowler’s position, and monitoring respiratory status, and assessing for complications. Assessing for the return of the gag reflex will prevent the client from choking or aspiration before eating. NPO status should be maintained until the return of gag reflex has been established. A minimal amount of blood is expected for a few hours after the procedure; however, excessive bleeding should be reported. Spitting into a basin instead of swallowing prevents the client from aspiration, as well as aids the nurse in monitoring blood in the sputum. Positioning the client on the side with the head of bed slightly raised is the positioning required for an unconscious client. If the client is conscious, the semi-Fowler’s position is indicated.

Test Taking Tip

Understand that postprocedure interventions for a bronchoscopy are concomitant with ensuring airway patency, preventing aspiration or choking, and assessing for complications.

Video Rationale