Following a diagnostic spinal tap, a client is transported back to the clinical unit. The client is alert and reports a dull ache near the lumbar insertion site. To promote client comfort and minimize the risk of procedural complications, which of the following actions should the nurse take?
- Ensure the client remains resting in a completely flat, horizontal position for the prescribed duration.Answer
- BRaise the upper half of the bed to a semi-upright angle to facilitate cerebrospinal fluid circulation.
- CEncourage the client to maintain a lateral fetal position with knees drawn toward the chest.
- DDirect an unlicensed assistive personnel to routinely inspect the lumbar dressing for clear drainage.
Answer
Ensure the client remains resting in a completely flat, horizontal position for the prescribed duration.
After a lumbar puncture, placing the client in a flat, supine posture is the standard evidence-based intervention. This position equalizes pressure in the central nervous system, drastically reducing the loss of cerebrospinal fluid through the puncture site and thereby preventing a post-dural puncture headache.
Step-by-Step Solution
Key Concept
Post-Lumbar Puncture Positioning and Comfort