NCM 106 SKILLS LABORATORY

BONE MARROW BIOPSY CHECKLIST

Name: _______________________________ Year & Sec.:______________________________ Rate: _______________________ Date: _______________________

PREPARATION 1. Explain to the client what you are going to do, why it is necessary, and how he can cooperate. 2. Wash hands and observe appropriate infection control procedures. 3. Gather all the materials needed. 4. Provide for client privacy. BEFORE THE PROCEDURE 1. Discuss with the patient that he/she may experience pain when the marrow is aspirated and hear a crunching sound as the needle is pushed through the cortex of the bone. The procedure usually takes 15 to 30 minutes. 2. Explain when and where the procedure will occur, who will be present, and which site will be used. 3. Help the client assume a supine position (with one pillow if desired) for the biopsy of the sternum (sterna puncture) or a prone position for a biopsy of either iliac crest. Fold the bedclothes back or drape the client to expose the area. 4. Administer a sedative as ordered. DURING THE PROCEDURE Monitor and support the client throughout: 1. Describe the step of the procedure as needed and provide verbal support. 2. Observe the client for pallor, diaphoresis, and faintness due to bleeding or pain.

PERFORMED YES NO

MASTERED

COMMENTS

REFERENCE: Barbara Kozier, et al, (2004). Fundamentals of Nursing: Concepts, Process and Practice (7th Edition, Pearson
Education South Asia Pte. Ltd

NCM 106 SKILL INVENTORY CLINICAL INSTRUCTORS:

Daniel B. Garcia Jr., RN, MSN, Josefina N. Bausa, RN, MANc, Cresmarie M. Custodio, RN, Jayson Caranto V. Caranto, RN, Karen C. Creus, RN, Milagros J. Nuez, RN, MAN

3. Place a small dressing over the site of the puncture after the needle is withdrawn: Some agencies protocols recommended direct pressure over the site for 5 to 10 minutes to prevent bleeding. 4. Assist with preparing specimen as needed. AFTER THE PROCEDURE A. Monitor the client: 1. Assess for discomfort and bleeding from the site. The client may experience some tenderness in the area. Bleeding and hematoma formation need to be assessed for several days. Reports bleeding or pain to the nurse in charge. 2. Provide an analgesic as needed and ordered. B. Document all relevant information: 1. Include date and time of the procedure, the physicians name; and any nursing assessment and interventions. 2. 3. Document any specimens obtained. Transport the specimens to laboratory. the

_______________________________ NAME AND SIGNATURE OF STUDENT

_______________________________________ NAME AND SIGNATURE OF CLINICAL INSTRUCTOR

REFERENCE: Barbara Kozier, et al, (2004). Fundamentals of Nursing: Concepts, Process and Practice (7th Edition, Pearson
Education South Asia Pte. Ltd

NCM 106 SKILL INVENTORY CLINICAL INSTRUCTORS:

Daniel B. Garcia Jr., RN, MSN, Josefina N. Bausa, RN, MANc, Cresmarie M. Custodio, RN, Jayson Caranto V. Caranto, RN, Karen C. Creus, RN, Milagros J. Nuez, RN, MAN