- The direct inspection and observation of the larynx, trachea, and bronchi through flexible or rigid bronchoscope.
- Flexible fiber-optic bronchoscope allows for more patient comfort and better visualization of smaller airways.
- Rigid bronchoscopy is preferred for small children and endobronchial tumor resection.
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- Has diagnostic and therapeutic uses in pulmonary conditions. Diagnostic uses include:
- Collecting secretions for cytologic/bacteriologic studies.
- Determining location and extent of pathologic process and obtaining tissue or brush biopsy for cytologic examination or culture.
- Determining whether a tumor can be resected surgically.
- Diagnosing bleeding sites (source of hemoptysis).
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- Therapeutic uses include removal of foreign bodies or thickened secretions from tracheobronchial tree and the excision of lesions.
Nursing and Patient Care Considerations
- Check that an informed consent form has been signed and that risks and benefits have been explained to the patient.
- Review and follow facility policy and procedure for conscious sedation.
- Administer prescribed medication to reduce secretions, block the vasovagal reflex, gag reflex, and relieve anxiety. Give encouragement and nursing support.
- Restrict fluid and food for 6 to 12 hours before procedure (to reduce risk of aspiration when reflexes are blocked).
- Remove dentures, contact lenses, and other prostheses.
- After the procedure:
- Monitor cardiac rhythm and rate, blood pressure, and level of consciousness.
- Withhold ice chips and fluids until patient demonstrates gag reflex.
- Monitor respiratory effort and rate.
- Monitor oximetry.
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- Promptly report cyanosis, hypoventilation, hypotension, tachycardia or dysrhythmia, hemoptysis, dyspnea, decreased breath sounds.
NURSING ALERT
After bronchoscopy, be alert for complications, such as pneumothorax, dysrhythmias, and bronchospasm.
