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Question

Difficulty: EasyReduction of Risk Potential

A client has just arrived on the medical unit after undergoing a bedside lumbar puncture. To minimize the risk of developing a cerebrospinal fluid leak and subsequent headache, which of the following positioning interventions should the nurse implement?

  1. A
    Elevate the head of the bed to a high Fowler's position
  2. B
    Place the client in a side-lying position with the knees flexed to the chest
  3. C
    Position the client in a modified Trendelenburg position
  4. Maintain the client in a supine position with the bed flatAnswer

Answer

The correct intervention is to maintain the client in a supine position with the bed flat.
Following a lumbar puncture, maintaining the client in a flat, supine position for a prescribed period helps prevent the leakage of cerebrospinal fluid from the dural puncture site, thereby significantly reducing the risk of a post-dural puncture headache.

Step-by-Step Solution

1
Identify the procedure performed and its primary post-procedure complication.
The client underwent a lumbar puncture, which carries a significant risk of cerebrospinal fluid (CSF) leakage and a resulting post-dural puncture headache.
Recognizing the specific risks associated with an invasive procedure is the first step in risk reduction.
2
Determine the appropriate physiological intervention to mitigate this risk.
Keeping the client supine and flat minimizes hydrostatic pressure at the dural puncture site in the lumbar spine.
Lower pressure at the puncture site allows the dural tissue to seal effectively, preventing ongoing CSF loss and avoiding the severe headache associated with decreased CSF volume.

Key Concept

Post-Lumbar Puncture Positioning and Complication Prevention
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Topics

Reduction of Risk Potential

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