LUMBAR PUNCTURE

Lumbar Puncture-It is the introduction of lumbar puncture

needle in the spinal canal for the purposes of removing spinal
fluid.

Purposes:
A.Diagnostic Purposes
To obtain a specimen of the spinal fluid in order to
ascertain nature of any foreign substances present to take on x-
ray of the spinal canal and cord in order to ascertain the nature
of location of any obstruction present.
B. Therapeutic Purposes
1. To reduce the intracranial pressure due to an excess of
the fluid
2. To introduce a serum or other medication
3. To inject to anesthetic
EQUIPMENT:
2 lumbar puncture needle
Gauze dressing
Plastic protector
A local anesthetic and a Hypodermic syringe and needle
Forceps
2 specimen tubes or bottles
Adhesive
Medication order
Alcohol
A manometer with tubing and a connector,if they pressure of
spinal fluid is to be measured
GENERAL INSTRUCTION
1. The perforation is usually made at the interspaced between
the third and fourth vertebrae, sometimes at that between
fourth and fifth vertebrae.
2. Counsel the client not to move while the needle is being
inserted or during treatment. Motion may cause an injury to
a nerve or interfere with process
3. Watch the client such that reaction as changes in pulse,
respiration or color and for signs of weakness, vertigo or
nausea.

PROCEDURE
1. Adjust the position of the client.He may lie on either side or
he may sit-up in bed or a chair or on table.His back shoud
be arched to bring out the spinouts processes and increase
the space between the vertebrae.
2. If the client is in bed let him lie at the rear side of the bed
with his shoulders and head bent forward and downward
and his knees drawn up toward his chin.
3. When the position has been adjusted , cleanse and disinfect
the gown
4. At this point the physician injects the anesthetic and inserts
the puncture needle.If the pressure of the spinal fluid is to
be read the needle is connected to the manometer.
5. When the fluid begins to drop,holds the specimen tubes
beneath the needle to collect the first drippings.These are
tinged with blood from the pierced tissue.Then the fluid
becomes clear use the second tube to collect it.
6. After the physician withdrawn the tube,wipe the area with
alcohol and put on dressing.
7. Let the client assume the dorsal position in bed.Pillows
should not be used and foot of the bed should be elevated to
bring the head lower than the pelvis.This possition should
be maintained for several hours or as indicated.The
removal of the fluid causes the decrease of the blood
pressure and consequently the circulatory disturbances that
lasts until the supply of fluid is again normal.However,if
the solution is equal in volume to that of the fluid
withdrawn is given,it is not necessary to maintain the dorsal
position for a long time
CHARTING

1. Record the time and duration of the treatment

2. The site of infection
3. By whom the needle was inserted and withdrawn
4. The position of the client
5. The amount and character of the fluid withdrawn
6. The medication given
7. The reaction of the client during and after the treatment.