SMS D-R PANCHE KRARAGJOZOV -SKOPJE

PATIENT PREPARATION

LUMBAR
PUNCTURE
PREPARING THE PAITENT AND MATERIAL
FOR THE PROCEDURE

Psychological preparation: the patient is told

what type of a procedure will be done on him, and
why its done. We must tell the
STUDENT:
patient
that
MENTOR:
IVAN ARSOVSKI
hes going to
NINA KNAGGS
MARKO NAUMOVSKI
VESNA ERBI
feel pain at the
ANDREJ CIKARSKI
time
of
the
puncture, to take a specific
position and to be steady and
calm for his own good. The patient lies on the side
and is near the edge of the bed. The head should
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be as close to the sternum as possible, and the

legs are curled up towards the stomach.

PREPARING MATERIAL AND PROVIDING

ASEPTIC CONDITIONS
A lumbar puncture it's a delicate procedure
done under sterile technique in the physician's
office. Most offices that perform lumbar punctures
set aside a special room for this procedure which
requires that the patient remains at the clinic for
several hours. Depending on the office protocol it
may be the nurses responsibility to continuously
monitor the patient's vital signs and alert the
family or the patient status. Family members are
sometimes allowed to stay with the patient during
the postoperative time.

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S NEEDED FOR THIS PROCEDURE

eptic
cator
ndages
ture needle
bes
e
d appropriately for the patient
to 2%
needle for anesthetic
es Fenestrated drape
ges

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FINAL PREPAIRMENTS
With the necessary materials you will be able to
assist the physician with the lumbar puncture to
obtain CSF correctly within the time determined
by
the
instructor.
Identify the patient and explain the procedure.
Reinforce the need for postoperative care.
Verify that the patient has signed a consent form
and that it has been filled in the chart.
Have the patient empty his or her bowel and
bladder.
Obtain the patient's vital signs
Wash your hands put on gloves and set up a tray
using sterile technique

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1.With the iodine in the kit disinfect the

puncture site (L3 and L4)
2.Have the patient lie on his or her left
side and curl into the fetal position.
Provide drapes for patients comfort.
3. Assist the physician as necessary in
swabbing/cleaning the patient with
antiseptic and placing the fenestrated
drape.
4.Assist the physician in aspirating the
xylocaine.
5.To avoid potential trauma to the spinal
cord, assist the patient in maintaining
the fetal position
6.While the physician is taking a pressure
reading, remind the patient to breathe
evenly and avoid talking. If the
physician requests, assist the patient in
straightening his or her legs to get the
true pressure reading
7.Place a gauze pad with firm pressure
over the puncture site to absorb any
bleeding.
8.After the fluid has been collected,
tighten the sample tubes and fill out the
lab order form correctly labeled the
samples for analysis.
9.Move the patient to the recovery area.
10.
Clean and disinfect the treatment
area.

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11.
Remove the gloves and wash your
hands.
12.
Document the procedure in the
patient's chart.

ASSISTING THROUGHOUT THE

MANIPULATION
PATIENT EDUCATION
The patient should be instructed to remain in a
prone position for 3 to 4 hours to allow CSF to be
replenished and the puncture site to heal. Make
sure the patient understands the importance of not
rushing through the vital healing process. The
patient should not attempt to sit upright for
extended periods and excessive moment can
cause spinal headache and potential damage. In
addition, the patient should increase fluid intake to
replace the lost fluid. Any tingling numbness
paralyzes or severe headaches should be reported
immediately

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