The client is having a lumbar puncture performed. The nurse would plan to place the client in which position for the procedure?
A. Side-lying, with legs pulled up and head bent down onto the chest.
B. Side-lying, with a pillow under the hip.
C. Prone, in a slight Trendelenburg’s position.
D. Prone, with a pillow under the abdomen.
Correct Answer: A. Side-lying, with legs pulled up and head bent down onto the chest
The client undergoing lumbar puncture is positioned lying on the side, with the legs pulled up to the abdomen, and with the head bent down onto the chest. This position helps to open the spaces between the vertebrae. The positioning of the patient in either a lateral recumbent position or sitting position may be used. The lateral recumbent position is preferred as it will allow an accurate measurement of opening pressure, and it also reduces the risk of post-lumbar puncture headache.
Option B: The patient should be instructed to assume the fetal position, which involves the flexion of the spine. It may be helpful to instruct the patient to flex their back “like a cat.” By doing so, the space between the spinous processes increases, allowing for easier needle insertion.
Option C: To help keep the needle at the midline during insertion, the lumbar spine should be perpendicular to the table in the sitting position and parallel to the table if in the recumbent position. Lumbar puncture is one of the most commonly performed procedures in the emergency department. It is used in the diagnosis of potentially life-threatening diseases such as meningitis and subarachnoid hemorrhage.
Option D: Lumbar puncture is a commonly performed procedure in the emergency department and can be of great clinical importance when diagnosing potentially lethal diseases such as meningitis and subarachnoid hemorrhage. With proper preparation, technique, and care, the risks of complications can be significantly reduced.
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