Set of activities performed by the nurse together with the physician to perform a lumbar puncture on the patient.
Objectives:
– To collaborate in performing a lumbar puncture on the patient for diagnostic and therapeutic purposes. – Prevent complications such as infection, neurological changes, etc.
Equipment:
– 2 sterile drapes. – Tray. – Sharps container.
Material:
– 2 intramuscular needles. – 2 ampoules of local anesthetic. – Antiseptic solution. – Sterile gauze. – Sterile gloves. – Non sterile gloves. – 1-2 syringes of 5-10 cc. – Test tubes. – Prescribed medication. – Lumbar puncture catheter. – Cerebrospinal fluid analysis request form. – Nursing records.
Procedure:
– Perform hand washing. – Prepare material. – Preserve the patient’s privacy. – Check that the patient and family have received medical information about the procedure. – Reassure the patient. – Ask for the patient’s cooperation. Warn the patient to notify immediately in case of severe pain in the lower extremities or in the groin area. – Place the patient in lateral decubitus at the edge of the bed, with the neck flexed, bringing the chin close to the chest. The back should remain straight. The knees should be bent over the abdomen and the patient, if possible, should support them with the arms, otherwise an orderly will help the patient to maintain the position. This technique can also be performed with the patient seated. – Ask the patient not to move and to breathe slowly. – Prepare a sterile field and place the necessary material on it. – Put on non-sterile gloves. – Apply antiseptic solution to the area to be punctured. Apply generously with circular movements from the inside out. – Assist the physician during the procedure. – Prepare sterile tubes to collect cerebrospinal fluid sample, if needed. – Continuously assess the patient for paleness, sweating, tingling, changes in level of consciousness. – Place dressing on the puncture site. – Keep the patient in absolute rest for the prescribed time. – Monitor vital signs every 30 minutes for the first 2 hours. – Place the patient in supine position after the procedure. – Collect the material. – Remove gloves. – Wash hands. – Identify the tubes with the patient’s data and send them to the laboratory with the analysis form. – Record in nursing documentation: procedure performed, date and time, incidents and patient response.
Observations:
Possible complications of lumbar puncture: hemorrhagic puncture, infections (meningitis) and transient post-puncture syndrome (headache, lumbago and radicular pain).
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