BONE MARROW ASPIRATTION

What is bone marrow aspiration?

A procedure in which a needle is inserted into a bone to withdraw a sample of liquid bone marrow for laboratory examination.

Why is bone marrow aspiration performed?

To evaluate blood-cell production and detect or investigate bone marrow disorders

What is the difference between bone marrow aspiration and bone marrow biopsy?

Aspiration obtains liquid marrow for cellular examination

Why is bone marrow examined when a patient has abnormal blood counts?

The CBC shows what is abnormal in circulating blood

What is the most common site for bone marrow aspiration in adults?

The posterior superior iliac crest because it contains abundant marrow and provides a relatively safe and accessible site.

Why is the posterior iliac crest commonly used for bone marrow aspiration?

It provides adequate marrow while reducing the risk of injury to major blood vessels and internal organs.

Why is the sternum generally not the routine site for bone marrow aspiration?

The sternum is close to vital structures such as the heart and major blood vessels

What is the primary function of bone marrow?

Bone marrow is a major site of hematopoiesis

Why might a patient with pancytopenia require bone marrow aspiration?

Pancytopenia means RBCs

Why is bone marrow aspiration commonly performed in suspected leukemia?

Leukemia involves abnormal proliferation of blood-forming cells in the marrow

What conditions may require bone marrow aspiration?

Aplastic anemia

Why may bone marrow aspiration be repeated in a patient with leukemia?

To evaluate response to treatment

What should the nurse verify before bone marrow aspiration?

Verify patient identity

Why must informed consent be verified before bone marrow aspiration?

Because it is an invasive procedure and the patient must understand its purpose

Why should the nurse review the platelet count before bone marrow aspiration?

Platelets are needed for primary hemostasis

Why should anticoagulant and antiplatelet medications be reviewed before bone marrow aspiration?

They can increase bleeding risk by interfering with coagulation or platelet aggregation; medication changes should follow the provider's order or facility protocol.

Why should the nurse assess the proposed puncture site for infection?

Inserting a needle through infected tissue can introduce microorganisms into deeper tissues and potentially cause or worsen infection.

What type of anesthesia is commonly used for bone marrow aspiration?

Local anesthesia is commonly used to numb the skin and underlying tissues around the insertion site.

Why can the patient still feel pressure or discomfort despite local anesthesia?

Local anesthesia reduces superficial pain

How is the patient generally positioned for posterior iliac crest aspiration?

The patient is commonly positioned prone or lateral depending on the provider's technique and the patient's condition

What is an important nursing responsibility during bone marrow aspiration?

Maintain aseptic technique

Why must aseptic technique be maintained during bone marrow aspiration?

The needle creates a pathway through the skin into deeper tissue and bone

Why should the nurse monitor vital signs during bone marrow aspiration?

Pain

What symptoms suggest a vasovagal reaction during bone marrow aspiration?

Pallor

What should the nurse do first if the patient becomes pale

dizzy

Why might a patient experience significant anxiety before bone marrow aspiration?

The patient may fear pain

What should the nurse explain about the sensation of bone marrow aspiration?

The patient may feel pressure or a brief pulling or aching sensation when the marrow is aspirated even after local anesthetic is applied.

What should the nurse do after the needle is removed?

Apply firm pressure to the puncture site as appropriate and place a sterile dressing according to facility protocol.

Why is pressure applied after bone marrow aspiration?

To promote hemostasis and reduce the risk of continued bleeding or hematoma formation.

What should the nurse assess at the puncture site after bone marrow aspiration?

Assess for bleeding

Which finding is generally expected after bone marrow aspiration?

Mild localized soreness or tenderness at the puncture site for a short period.

Which findings after bone marrow aspiration should concern the nurse?

Persistent or heavy bleeding

Why is persistent bleeding after bone marrow aspiration particularly concerning in a patient with thrombocytopenia?

Low platelet levels impair primary hemostasis

What are the major complications of bone marrow aspiration?

Pain

A patient has a dressing saturated with blood after bone marrow aspiration. What is the priority concern?

Active bleeding; assess the patient and puncture site

Why must the bone marrow specimen be correctly labeled and promptly transported?

The specimen is used for diagnostic testing

What tests may be performed on a bone marrow specimen?

Morphologic examination

What should the patient be taught to report after bone marrow aspiration?

Persistent or heavy bleeding

Why does a patient with an abnormal CBC sometimes need bone marrow aspiration?

The CBC identifies abnormalities in circulating blood cells

What is the high-yield nursing sequence for bone marrow aspiration?

Verify