A male client is having a lumbar puncture performed. The nurse would plan to place the client in which position?
A. Side-lying, with a pillow under the hip.
B. Prone, with a pillow under the abdomen.
C. Prone, in slight-Trendelenburg’s position.
D. Side-lying, with the legs, pulled up and head bent down onto the chest.
Correct Answer: D. Side-lying, with the 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 the head bent down onto the chest. This position helps open the spaces between the vertebrae.
Option A: 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: 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.
Option C: 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.
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