Question

A nurse is preparing an adolescent for a lumbar puncture: True/ False Which of the following actions should the nurse take?

a) Place a cardiac monitor on the adolescent prior to the procedure: True/ False
b) Apply topical analgesic cream to the site 1 hr prior to the procedure: True/ False
c) Keep the adolescent in a semi-Fowler's position for 4 hr following the procedure: True/ False
d) Restrict fluids for 2 hr following the procedure: True/ False

Answer 1

a) False

b) True

c) False

d) False

Step-by-step explanation:

The correct actions for preparing an adolescent for a lumbar puncture are as follows:

a) Placing a cardiac monitor on the adolescent is not typically necessary for a lumbar puncture, making option (a) false.

b) Applying topical analgesic cream to the site 1 hour prior to the procedure is a recommended practice for reducing pain and discomfort, making option (b) true.

c) Keeping the adolescent in a semi-Fowler's position for 4 hours following the procedure is not a standard protocol; hence, option (c) is false.

d) Restricting fluids for 2 hours following the procedure is not a standard practice and could potentially lead to dehydration; therefore, option (d) is false.

In preparation for a lumbar puncture, it is essential to prioritize the comfort and well-being of the patient. While a cardiac monitor is not typically required, applying a topical analgesic cream helps manage pain at the puncture site. However, keeping the adolescent in a semi-Fowler's position for an extended period and restricting fluids are not standard procedures and may not contribute positively to the patient's recovery. Clear communication with the patient and adherence to evidence-based practices are crucial aspects of ensuring a safe and effective lumbar puncture procedure.

Answer 2

In a lumbar puncture, the needle is inserted in the lower lumbar region to safely sample CSF below the level of the spinal cord. Cardiac monitoring is not standard unless there are cardiac concerns, topical analgesic cream can be used for comfort, post-procedure positioning typically involves lying flat, not semi-Fowler's, and fluid intake should not be restricted after the procedure. Option a,c and d is false, option b is true.

Step-by-step explanation:

A lumbar puncture is a medical procedure that involves the insertion of a needle into the lower lumbar area of the vertebral column to sample cerebrospinal fluid (CSF). This location is chosen because it is safely below the level of the spinal cord in adults and older children, which ends around the L1-L2 vertebrae, minimizing the risk of damage to the spinal cord.

Regarding the preparations and aftercare for the procedure:

• a) Placing a cardiac monitor on the adolescent prior to the procedure is generally not required for a lumbar puncture, unless the patient has specific cardiac issues that warrant monitoring.
• b) Applying a topical analgesic cream to the puncture site 1 hour prior to the procedure is a beneficial step to minimize the discomfort of the puncture.
• c) Keeping the adolescent in a semi-Fowler's position (upright at a 45-degree angle) for 4 hours following the procedure is not the standard care. Post-lumbar puncture care typically involves lying flat, which may help prevent post-procedure headaches.
• d) Restricting fluids for 2 hours following the procedure is not a typical recommendation. Adequate fluid intake is important after a lumbar puncture to help replenish CSF and reduce the chance of headache.