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Difficulty: MediumBasic Care and Comfort

Following a lumbar puncture, an adult client is admitted to the medical-surgical unit for observation. The client is awake, alert, and has stable vital signs. Which positioning measure must the practical nurse implement to minimize the risk of complications?

  1. Maintain the client in a flat, supine position for the duration prescribed by the healthcare provider.Answer
  2. B
    Assist the client into a side-lying position with the knees drawn up tightly toward the chest.
  3. C
    Elevate the head of the bed to a 45-degree angle to promote optimal respiratory expansion.
  4. D
    Place the client in a prone position with a small pillow tucked under the abdomen for spinal support.

Answer

Maintain the client in a flat, supine position for the duration prescribed by the healthcare provider.
Following a lumbar puncture, the client should be kept in a flat, supine position for several hours as prescribed by the provider. This position is critical because it helps prevent a post-dural puncture headache (often called a spinal headache) by reducing the gravitational hydrostatic pressure that causes cerebrospinal fluid (CSF) to leak from the dural puncture site.

Step-by-Step Solution

1
Analyze the physiological impact of the procedure.
A lumbar puncture involves puncturing the dura mater to access the subarachnoid space, which creates a small pathway where cerebrospinal fluid (CSF) can potentially leak.
Understanding the procedure highlights the specific post-procedure risks, primarily a post-dural puncture headache (spinal headache).
2
Evaluate the effect of gravity and positioning on CSF pressure.
Sitting upright or elevating the head increases hydrostatic pressure on the lower spine, forcing more CSF out of the puncture site.
Identifying what exacerbates the complication dictates the required nursing intervention.
3
Determine the optimal therapeutic position.
A flat, supine position distributes pressure evenly and minimizes gravitational force on the lumbar puncture site, allowing the dura to seal.
This directly mitigates the primary complication associated with the procedure.

Key Concept

Post-Lumbar Puncture Positioning
Estimated Time:1m 0s
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Topics

Basic Care and Comfort

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