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Question

Difficulty: EasyReduction of Risk Potential

A client arrives on the medical unit immediately after undergoing a diagnostic lumbar puncture. To decrease the risk of a cerebrospinal fluid leak and subsequent post-procedure headache, which position is most appropriate for the nurse to implement?

  1. A
    Side-lying with the knees pulled to the chest
  2. Supine with the head of the bed flatAnswer
  3. C
    Semi-Fowler's with the head elevated 45 degrees
  4. D
    Prone with a pillow placed under the abdomen

Answer

The most appropriate position is supine with the head of the bed flat.
Following a lumbar puncture, the client must remain flat to prevent cerebrospinal fluid (CSF) from leaking out of the dural puncture site. A flat position equalizes pressure along the spinal column, which is the primary intervention to prevent post-dural puncture headaches.

Step-by-Step Solution

1
Identify the primary complication associated with the procedure.
Following a lumbar puncture, clients are at risk for a cerebrospinal fluid (CSF) leak, which leads to a severe post-dural puncture headache.
Understanding the mechanism of the complication determines the necessary nursing intervention.
2
Determine the physical position that mitigates this specific risk.
The flat, supine position eliminates the gravity-induced pressure gradient at the spinal puncture site.
Keeping the pressure equalized prevents CSF from escaping through the unhealed dural membrane.

Key Concept

Post-Lumbar Puncture Positioning
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Topics

Reduction of Risk Potential

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