ASSISTINGWITHLUMBARPUNCTURE

NursingResponsibilities

Jan Carlo B. Evangelista

Reporter

BEFORETHEPROCEDURE

BEFORETHEPROCEDURE

Prepare the client: • Explain the procedure to the client and support

persons. The primary care provider will be taking a small sample of spinal fluid from the lower spine. A local anesthetic will be given to minimize the discomfort.

• Explain when and where the procedure will occur (e.g., the bedside or the treatment room) and who will be present (e.g., the primary care provider and the nurse).

BEFORETHEPROCEDURE• Explain that it will be necessary to lie in a certain

position without moving for about 15 minutes. A slight pinprick will be felt when the local anesthetic is injected and a sensation of pressure as the spinal needle is needed.

• Have the client empty the bladder and bowels prior to the procedure to prevent unnecessary discomfort.

• Position and drape the client. • Open the lumbar puncture set.

BEFORETHEPROCEDURE

BEFORETHEPROCEDURE

DURINGTHEPROCEDURE

DURINGTHEPROCEDURE

Support and monitor the client throughout: • Stand in front of the client and support the back of

the neck and knees if the client needs help remaining still.

• Reassure the client throughout the procedure by explaining what is happening. Encourage normal breathing and relaxation.

• Observe the client’s color, respirations, and pulse during the procedure. Ask the client to report headache or persistent pain at the insertion site.

DURINGTHEPROCEDURE

Handle specimen tubes appropriately: • Wear gloves when handling test tubes. • Label the specimen tubes in sequence. • Send the CSF specimens to the lab

immediately. Place a small sterile dressing over the puncture

site.

DURINGTHEPROCEDURE

AFTERTHE

PROCEDURE

AFTERTHEPROCEDURE

Ensure the client’s comfort and safety: • Assist the client to a dorsal recumbent position with

only one head pillow. The client remains in this position for 1 to 12 hours, depending on the primary care provider orders.

• Determine whether analgesics are ordered and can be given for headaches.

• Offer oral fluids frequently, unless contraindicated, to help restore the volume of CSF.

AFTERTHEPROCEDURE

Monitor the client: • Observe for swelling or bleeding at the

puncture site. • Monitor changes in neurologic status. • Determine whether the client is experiencing

any numbness, tingling, or pain radiating down the legs.

AFTERTHEPROCEDURE

Document the procedure on the patient’s chart: • Include date and time performed; the primary

care provider’s name; the color, character, and amount of CSF; and the number of specimens obtained. Also document CSF pressure and the nurse’s assessments and interventions.

- END -

Thank you.ü

-cxdjIIdreamer