Lumbar Tap

ASSISTINGWITH LUMBARPUNCTURE

NursingResponsibilities

Jan Carlo B. Evangelista Reporter

BEFORETHEPROCE DURE

BEFORETHEPROCEDURE Prepare the client: • Explain the procedure to the client and support persons. The primary care provider will be taking a small sample of spinal fluid from the lower spine. A local anesthetic will be given to minimize the discomfort. • Explain when and where the procedure will occur (e.g., the bedside or the treatment room) and who will be

BEFORETHEPROCEDURE • Explain that it will be necessary to lie in a certain position without moving for about 15 minutes. A slight pinprick will be felt when the local anesthetic is injected and a sensation of pressure as the spinal needle is needed. • Have the client empty the bladder and bowels prior to the procedure to prevent unnecessary discomfort. • Position and drape the client.

BEFORETHEPROCEDURE

BEFORETHEPROCEDURE

DURINGTHEPROCED URE

DURINGTHEPROCEDURE Support and monitor the client throughout: • Stand in front of the client and support the back of the neck and knees if the client needs help remaining still. • Reassure the client throughout the procedure by explaining what is happening. Encourage normal breathing and relaxation. • Observe the client’s color, respirations, and pulse during the procedure. Ask the client to report headache or persistent

DURINGTHEPROCEDURE Handle specimen tubes appropriately: • Wear gloves when handling test tubes. • Label the specimen tubes in sequence. • Send the CSF specimens to the lab immediately. Place a small sterile dressing over the puncture site.

DURINGTHEPROCEDURE

AFTERTH E

PROCED URE

AFTERTHEPROCEDURE Ensure the client’s comfort and safety: • Assist the client to a dorsal recumbent position with only one head pillow. The client remains in this position for 1 to 12 hours, depending on the primary care provider orders. • Determine whether analgesics are ordered and can be given for headaches. • Offer oral fluids frequently, unless contraindicated, to help restore the volume of CSF.

AFTERTHEPROCEDURE Monitor the client: • Observe for swelling or bleeding at the puncture site. • Monitor changes in neurologic status. • Determine whether the client is experiencing any numbness, tingling, or pain radiating down the legs.

AFTERTHEPROCEDURE Document the procedure on the patient’s chart: • Include date and time performed; the primary care provider’s name; the color, character, and amount of CSF; and the number of specimens obtained. Also document CSF pressure and the nurse’s assessments and interventions.

- END Thank you.ü

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