5. ï± To diagnosis/ staging of diseases
ï¶ Leukemia
ï¶ Multiple myeloma
ï¶ Lymphoma
ï¶ Anemia
ï¶ Thrombocytopenia
ï¶ Pancytopenia
ï± To monitor the development of hemolytic
disease and respond towards the treatment given.
ï± To obtain more information on hematopoiesis.
8. ï± Iliac Crest ( posterial and superior part, client
lie on lateral or prone position)
ï± Sternum (2nd space of sternum)
ï± Tibia Crest ( babies below 1 year)
11. ï± Bleeding disorders
ï± Infection of the skin overlying the area from
which the biopsy is to be taken
ï± Infection in the bloodstream
ï± Severe osteoporosis
12. ï± Check doctorâs order in progress note:
ï± Right client
ï± Selected site for procedure
ï± Any pre-medication order
ï±Check for consent form is sign by doctor and client.
ï± Assess clientâs:
ï±Lever of consciousness or restless
ï±Ability to assume position required for
procedure.
13. ï± Skin of procedure site
ï± Vital sign
ï±Notify for lab Technician on call
ï± Prepare environment
14. ï± Second nurse as assistant
ï± Lab technician with glass slide
15. ï± Carbolised tray
ï± Big tray with:
âą Disposable dressing set
âą Extra cotton balls and gauzes
âą 1 pair of sterile gloves
âą Face mask
âą 1 Fenestrated towel
âą Bone marrow aspiration needle with inner stylet
âąCleansing solution (surgiacal spirit 70% and
Povidone.
16. âą Lignocaine 1% or 2%
âą Syringes: 3mlĂ2, 5mlĂ2 and 20mlĂ2
âą Needles: 18GĂ2 and 23GĂ2
âą Heparin saline 5mlĂ2
âą Elastoplast
âą Medication tray with prepared pre-medication
drugs.
ï±Laboratory form according to type of test.
17. ï±Wash hand.
ï±Greet client and check ID tag.
ï±Explain procedure.
ï±Provide privacy.
ï±Adjust bed.
ï±Second nurse position client according to
doctorâs chosen site for procedure.
ï±Expose insertion site and place incopad
underneath.
18. ï±1st nurse assist the doctor throughout procedure:
âą open dressing set follow by all sterile items as
per requirement needs.
âą Pour solution
âą Give assistant to doctor when necessary
ï±2nd nurse observe clientâs condition for difficulty
in breathing or unbearable pain throughout the
procedure.
ï± Maintain client in supine position and check
clientâs vital sign hourly for 4 hours.
19. ï±Make client comfort.
ï± Put up both cot side and place call bell within
the clientâs reach.
ï±Cleat trolley and wash hands.
ï± Document in nursing care plan.
20.
21. ï± Physical preparation
âą Make sure the doctor have obtain consent
from client
âą Provide clear explanation
âą Make sure the puncture site has been cleaned
âą check vital sign.
22. ï± Prepare equipments
âąPrepare trolley aseptically
âąMake sure equipments are complete
ï±Make sure laboratory technicians has been
inform more earlier.( Technician must be present
during procedure because aspirated bone marrow
is smeared immediately on a glass slide.)
23. ï± Help client to remain in the right position
ï± Assist the doctor in the procedure. ( Prepare
the equipments and hold the client)
ï± Monitor vital signs during procedure to dectect
complication.
24. ï± Place the client in supine position and apply
sandbag at the puncture site at least for 6 hours
to prevent bleeding complication.
ï± Observe the pressure dressing is tight, clean
and no signs of bleeding to prevent infection.
ï± Observe the client until their condition stable
and recover.
ï±Monitor vital signs after the procedure.
25. ï± Tidy the equipment and make sure CSSD
instruments are complete before sending to
autoclave.