The nurse is caring for the client following a liver biopsy with the assistance of the student nurse. Which action by the student nurse demonstrates an understanding of the post-procedural care?

Rationale: A. After a liver biopsy, the risk of complications such as hemorrhage is highest in the first few hours. Therefore, vital signs should be assessed every 15 minutes for the first hour, every 30 minutes for the second hour, and then hourly if stable. Waiting an entire hour between assessments is inadequate and could delay detection of hypotension, tachycardia, or other early signs of internal bleeding. B. After a liver biopsy, it is standard practice to position the client on their right side with a pillow or small cushion under the puncture site. This applies direct pressure to the liver to help achieve hemostasis, reducing the risk of post-procedural bleeding or hematoma formation. Maintaining this position for at least 2 to 4 hours is recommended. This action reflects a clear understanding of post-procedural care and the priority of protecting the biopsy site. C. Clients are typically instructed to remain on bed rest for 2 to 6 hours, depending on provider protocol. Early ambulation increases intra-abdominal pressure and raises the risk of bleeding or dislodging the clot at the biopsy site, potentially leading to hemorrhage, hypotension, and pain. D. While coughing and deep breathing are important for preventing pulmonary complications like atelectasis, they should be avoided immediately after a liver biopsy. Forceful coughing or deep breathing increases intra-abdominal pressure, which can disrupt the liver puncture site, cause bleeding, and lead to pain or hematoma formation.