Before performing a renal biopsy with needle insertion, which preprocedure assessment is most important for the nurse to perform?

• A. BUN and creatinine
• B. NPO status and signature on consent
• C. Bleeding time and coagulation studies
• D. Serum potassium and urine sodium

Answer: (C)

The most important preprocedure assessment is evaluating the patient’s ability to clot. A renal biopsy involves inserting a needle into the kidney, a procedure with a real risk of bleeding into the kidney or retroperitoneal space. Checking bleeding time and coagulation studies (such as PT/INR, aPTT) and ensuring an adequate platelet count directly addresses this risk. If coagulation is prolonged or platelets are low, the procedure may need to be postponed or corrected before proceeding, to prevent serious hemorrhage.

Other items like BUN and creatinine assess kidney function, which is important for overall care but does not determine bleeding risk. NPO status and consent are essential for safety and legal reasons, but they do not mitigate the specific risk of hemorrhage. Serum potassium and urine sodium likewise relate to metabolic status rather than the immediate risk of bleeding.