Bronchoscopy

Category: Pulmonary

🔍 Indications

Diagnostic:

['Direct visualization of tracheobronchial tree for abnormalities', 'Direct visualization of larynx to determine vocal cord paralysis', 'Aspiration of specimen for culture and sensitivity', 'Biopsy of tissue from suspected lesions']

Therapeutic:

['Removal of excessive secretions, mucus plugs, tumors', 'Removal of foreign objects', 'Control of bleeding in bronchi', 'Palliative laser therapy for bronchial tumors']

⚠️ Contraindications

Uncooperative patients
Uncorrectable coagulopathy
Severe acute respiratory failure with hypercapnia
Severe tracheal obstruction
Recent myocardial infarction or unstable angina
Recent head trauma (risk of increased ICP)

⚕️ Procedure

Local anesthetic flushed into throat (patient sitting or supine).
Bronchoscope inserted through mouth or nose.
Additional lidocaine sprayed through scope to anesthetize vocal cords.
Practitioner examines trachea and bronchi structure and color.
Tissue samples may be collected from suspect areas.

📋 Nursing Care

Before:

Secure informed consent
Obtain medical history (allergies, medications)
Check NPO status (withhold food/fluids 6-12 hours)
Monitor baseline vital signs
Provide oral hygiene; remove dentures
Administer preoperative medications as ordered
Prepare for local anesthesia
Relieve anxiety; reassure about airway safety
Prepare emergency resuscitation equipment

During:

Position client in sitting or supine position
Provide supplemental oxygen as ordered
Assist with tissue specimen collection
Secure and label specimens properly

After:

Observe for excessive bleeding
Assess respiratory status (bronchial spasm, perforation)
Monitor vital signs
Position conscious patient in semi-Fowler's
Maintain NPO until gag reflex returns
Provide emesis basin; instruct to spit out saliva
Reassure that hoarseness and sore throat are temporary
Offer lozenges or soothing gargle when safe