Rohilkhand College of Nursing, Bareilly

Procedure Checklist
“Assisting in Kidney Biopsy”
S/N Procedure 1 2 3 4 5
1. Ensure that X-ray films, IVP results and bleeding parameters are available
before the procedure.
2. Explain the procedure and get consent
3. Assemble equipment on trolley in treatment room.
4. Take patient to treatment room
5. Assist patient to lie in prone position
6. Place Sand bag or firm pillow under abdomen
7. Assist in cleaning area with antiseptic & draping the site with sterile towel.
8. Assist in local infiltration with 2% xylocaine
9. Assist in making small stab incision through skin and inserting biopsy needle
10. Instruct the patient to take a deep breath and hold it while biopsy is being
taken
11. Reassure the patient while doctor removes the needle
12. Place dry sterile gauze over the site and fix with broad adhesive strip.
13. Turn the patient to supine position slowly and make him/her comfortable
14. Preserve biopsy specimen in formalin bottle/wet gauge blotting paper and
label it.
15. Replace equipment
16. Document the time of biopsy, success of procedure, the patient’s condition
and vital signs.
POST PROCEDURE CARE
17. After half an hour, transfer patient from treatment room to bed on stretcher
18. Explain to the patient about the need for strict bed rest for 24 hours and to
avoid coughing or sneezing
19. Check vital signs, BP, Pulse and respiratory rate every 1/4th h for first 1 hr,
every ½ hr for next 2 hours and every hour for next 3 hours.
20. Instruct the patient to drink at least 2000-3000ml of fluid in next few hours.
21. Give three small, labelled bottles to collect the first three urine specimens
22. Inform doctor in case of haematuria, drop in BP, rise in pulse rate, abdominal
pain or any unusual symptoms.
23. Check biopsy site periodically, Assess for tightness of adhesive and take
appropriate action.
TOTAL SCORE

OBTAINED SCORE

PERCENTAGE

REMARK

Name of the student_____________________________ Date_________________ 

 Course__________________________________ Class ________________

Name of Instructor/Evaluator:_____________________ Ward/Unit________________

Signature: __________________________

6- Highly Satisfactory – 85-100 Percentage

5 -Satisfactory – 69 – 84 Percentage
4 -Moderately Satisfactory- 52 to 68 Percentages
3 - Moderately Unsatisfactory- 35 to 51 Percentages
2 -Unsatisfactory – 18 to 34 Percentages
1 -Highly Unsatisfactory – 0-17 Percentage

Note:
1. 1, 2, 3, 4, 5 denoting attempt made by the students
2. Each statement will be score by Yes/No and yes contain 1 point & no contain zero point
3. Students who get 85 % or above will get full satisfactory and below will have to make
attempt till the candidate get 85% or above

Remarks by Evaluator: ________________________________________________________

PRINCIPAL