lumbar tap
DESCRIPTION
Nursing responsibilities before, during, and after lumbar puncture.TRANSCRIPT
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ASSISTINGWITHLUMBARPUNCTURE
NursingResponsibilities
Jan Carlo B. Evangelista
Reporter
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BEFORETHEPROCEDURE
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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 present (e.g., the primary care provider and the nurse).
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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. • Open the lumbar puncture set.
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BEFORETHEPROCEDURE
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BEFORETHEPROCEDURE
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DURINGTHEPROCEDURE
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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 pain at the insertion site.
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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.
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DURINGTHEPROCEDURE
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AFTERTHE
PROCEDURE
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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.
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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.
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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.
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- END -
Thank you.ü
-cxdjIIdreamer