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Difficulty: MediumBasic Care and Comfort

An adult client is brought back to the inpatient room immediately after undergoing a diagnostic lumbar puncture. The provider has prescribed bed rest for the next several hours. Which action should the practical nurse take regarding the client's bed positioning to promote comfort and prevent complications?

  1. Ensure the client remains completely horizontal on their back.Answer
  2. B
    Assist the client into a seated alignment with the head elevated to 45 degrees.
  3. C
    Help the client maintain a lateral posture with the knees drawn tightly to the chest.
  4. D
    Turn the client to a prone orientation with a firm pillow placed under the abdomen.

Answer

Ensure the client remains completely horizontal on their back.
Following a lumbar puncture, maintaining the client in a flat, horizontal alignment prevents cerebrospinal fluid from leaking out of the puncture site. This intervention is critical for preventing a severe post-dural puncture headache (spinal headache), as it keeps cerebrospinal pressure equalized across the dural space.

Step-by-Step Solution

1
Identify the completed procedure and its associated risks.
The client underwent a lumbar puncture, which carries a high risk for cerebrospinal fluid (CSF) leakage from the dural puncture site.
Understanding the physiological risks of the procedure dictates the appropriate basic care intervention.
2
Determine the optimal anatomical alignment to minimize this specific procedural risk.
A flat, horizontal alignment equalizes CSF pressure and minimizes the gravity-assisted leakage of fluid.
Gravity exacerbates CSF leakage if the head and torso are elevated, leading to a debilitating spinal headache.
3
Select the nursing intervention that matches this physiological requirement.
Keeping the client completely horizontal on their back is the correct post-procedural positioning.
This specific bed positioning directly promotes comfort by preventing the most common post-lumbar puncture complication.

Key Concept

Post-Lumbar Puncture Care and Positioning
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Topics

Basic Care and Comfort

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