In caring for a client undergoing thoracentesis, the nurse should instruct the client that:
A) a thin gauge needle will be inserted into the tumor.
B) a thin tube will be inserted through the nose and down the trachea to the lung.
C) a small incision will be made in the neck above the sternum.
D) a large gauge needle will be inserted into the pleural space.
D) a large gauge needle will be inserted into the pleural space.
Explanation: A) This procedure describes tumor biopsy, requiring insertion of a thin needle into a peripheral tumor to obtain a sample for histology.
B) This procedure describes bronchoscopy, which is the insertion of a thin lighted tube through the nose or mouth, down the trachea to the lung. Any suspicious-appearing tissue can be lavaged (washed), brushed, or biopsied for cells for cytologic or histologic analysis.
C) A small incision as described would be needed for a mediastinoscopy procedure, which is used to sample lymph node tissue in the upper mediastinum. A small incision is made in the neck above the sternum, a thin lighted scope is inserted into the mediastinum, and suspicious nodes can be biopsied.
D) Thoracentesis requires insertion of a large-gauge needle into the pleural space to remove fluid and cells for cytologic analysis. The needle is large gauge to allow removal of sufficient fluid. In addition to thoracentesis being used as a diagnostic procedure, it is often necessary to remove large volumes of fluid when pleural fluid buildup interferes with breathing.
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