Medical Surgical Bronchoscopy #5

Question

The nurse is caring for a client post-bronchoscopy. Which observation by the nurse indicates a complication?

Answers

  1. Facial and neck crepitus.
    • Rationale:

      This answer is correct because facial and neck crepitus are signs of subcutaneous emphysema. Subcutaneous emphysema can be caused by a tear in the trachea or bronchi post-bronchoscopy. This occurs when air containing structures rupture, allowing dissection of air into nearby tissues.

  2. Bloody sputum.
    • Rationale:

      This answer is not correct because bloody sputum is normal and expected post-bronchoscopy. Only copious amounts of blood in the sputum should be reported.

  3. Difficulty swallowing.
    • Rationale:

      This answer is not correct because swallowing difficulty is expected post-bronchoscopy. This is because the client’s throat was anesthetized, causing a reduced gag reflex.

  4. Oxygen saturation 93%.
    • Rationale:

      This answer is not correct because an oxygen saturation of 93% post-bronchoscopy is not concerning, as is facial and neck crepitus. If the client’s oxygen goes below 90% and the client begins to show signs of mental status changes, that would be a concern.

Overview

A bronchoscopy is an invasive procedure used to directly visualize the larynx, trachea, and bronchi. Complications can include bronchospasms, bronchial perforation, dysrhythmias, infection, hemorrhage, pneumothorax, and hypoxemia.

Explanation

Learning Outcomes

A bronchoscopy is an invasive procedure used to directly visualize the larynx, trachea and bronchi. Complications can include bronchospasm, bronchial perforation, dysrhythmias, infection, hemorrhage, pneumothorax, and hypoxemia. Facial and neck crepitus are signs of subcutaneous emphysema. Subcutaneous emphysema can be caused by a tear in the trachea or bronchi post-bronchoscopy. Bloody sputum only becomes a concern if there is an excess of blood. Difficulty swallowing is expected until the client’s gag reflex returns. Oxygen saturation of 93% is not concerning.

Test Taking Tip

Do not forget that the major risk of bronchoscopy is bleeding. Bleeding can cause subcutaneous emphysema which results in crepitus.

Video Rationale