Question

The nurse is assisting with a lumbar puncture. Place the following steps of the procedure in the order in which they are usually performed (1-5).

A. Place the patient near the edge of the bed, lying on one side, with knees flexed into the abdomen and chin tucked against the chest.

B. Assess for signs of hypotension or shock.

C. Hold pressure on the puncture site for at least 5 minutes.

D. Cleanse the injection site.

E. Apply a bandage, small dressing, or occlusive pressure dressing.

Answer 1

The lumbar puncture procedure steps include (A) positioning the patient properly , (D) cleansing the site,
(B) performing the puncture, (C) holding pressure on the site post-procedure, and (E) then bandaging. The lumbar puncture is performed in the lower lumbar region to avoid damaging CNS tissue, as the spinal cord does not extend into the lower lumbar vertebrae.

Step-by-step explanation:

The steps for assisting with a lumbar puncture are typically performed in the following order:

1. Position the patient near the edge of the bed, lying on one side, with knees flexed into the abdomen and chin tucked against the chest.
   
   
2. Cleanse the injection site to ensure a sterile environment for the procedure.
   
   
3. Perform the lumbar puncture by inserting the needle to withdraw CSF (cerebrospinal fluid).
   
   
4. Hold pressure on the puncture site for at least 5 minutes to prevent bleeding and CSF leakage.
   
   
5. Apply a bandage, small dressing, or occlusive pressure dressing to the site post-procedure.

Afterwards, it's important to assess for signs of hypotension or shock to monitor the patient's vital signs for any adverse effects from the procedure. The lumbar puncture is performed in the lower lumbar area of the vertebral column because it is a relatively safe location to insert a needle. This area is chosen to avoid the risk of damaging CNS tissue, as the spinal cord ends at the upper lumbar vertebrae, making it less likely to be injured during the procedure.