Examkin

Soru

Zorluk: KolayBasic Care and Comfort

A nurse is planning care for a client who has just returned to the medical-surgical unit following a lumbar puncture. Which of the following positions should the nurse maintain for this client immediately after the procedure?

  1. Supine with the head of the bed flatCevap
  2. B
    High-Fowler's position with the knees slightly flexed
  3. C
    Side-lying position with the knees drawn up to the chest
  4. D
    Semi-Fowler's position with a pillow under the head

Cevap

Supine with the head of the bed flat
Following a lumbar puncture, the client should be maintained in a flat, supine position for a prescribed period (typically 4 to 8 hours). This position minimizes the pressure on the dural puncture site, preventing the leakage of cerebrospinal fluid (CSF) and significantly reducing the risk of a post-dural puncture headache.

Adım Adım Çözüm

1
Identify the procedure the client underwent.
The client had a lumbar puncture, which involves puncturing the dura mater to access cerebrospinal fluid (CSF).
Specific post-operative complications are associated with different procedures.
2
Recall the potential complications of a lumbar puncture.
A major complication is a CSF leak from the puncture site, leading to a severe spinal headache.
Understanding the risk guides the primary nursing intervention.
3
Determine the appropriate position to prevent this complication.
Keeping the client flat distributes CSF pressure evenly and minimizes hydrostatic pressure at the dural puncture site.
Gravity exacerbates CSF leakage if the head is elevated.

Anahtar Kavram

Post-procedure positioning to prevent complications (Lumbar Puncture)
Tahmini Süre:45s
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Konular

Basic Care and Comfort

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