Question

A client has been scheduled for a lumbar puncture. Which would the nurse include in the implementation plans? A. Get the consent form signed for the lumbar puncture procedure B. Place the client in the prone position during the procedure C. Instruct the client that there will be no pain or discomfort D. Encourage fluid intake to assure a full bladder

Short answer

A. Get the consent form signed for the lumbar puncture procedure. B. Place the client in the prone position during the procedure. C. Instruct the client that there will be no pain or discomfort. D. Encourage fluid intake to assure a full bladder. Answer: A. Get the consent form signed for the lumbar puncture procedure.

Step-by-step solution

Explore options A, B, C, and D

First, we need to understand each of the given options: Option A: Get the consent form signed for the lumbar puncture procedure. Option B: Place the client in the prone position during the procedure. Option C: Instruct the client that there will be no pain or discomfort. Option D: Encourage fluid intake to assure a full bladder.

Rule out inappropriate options

Next, we'll rule out options that are clearly not appropriate or necessary for a lumbar puncture procedure: Option C: Telling a client there will be no pain or discomfort is not accurate. While the procedure should not cause significant pain, there might be some discomfort. Hence, this option is not suitable. Option D: Encouraging fluid intake to assure a full bladder is not useful for a lumbar puncture procedure. It is not relevant to the procedure, so we can rule this option out. Now, we are left with options A and B.

Compare the remaining options

We will now compare options A and B to determine which one is the most appropriate nursing action as part of the implementation plan for a lumbar puncture procedure. Option A: Getting the client's consent is an essential step before any invasive procedure. A lumbar puncture is an invasive technique that requires written informed consent from the patient. Option B: The prone position is not the correct position for a lumbar puncture procedure. For a lumbar puncture, the client usually lies in the lateral recumbent position (on their side), with knees drawn up to the chest. This position opens the spaces between vertebrae, allowing better access to the spinal canal.

Select the correct answer

Based on our analysis, option A is the most appropriate nursing action as part of the implementation plan for a lumbar puncture procedure. The correct answer is: A. Get the consent form signed for the lumbar puncture procedure.

Key concepts

Nursing Procedures

Nursing procedures are specific methods and steps nurses follow to ensure patient care is conducted safely and effectively. Conducting a lumbar puncture involves several key steps, where each part of the process must be carefully managed to ensure both safety and accuracy.

• Preparation for Procedure: The nurse must prepare the patient both physically and psychologically for the lumbar puncture. This may involve explaining the procedure to the patient to ensure comfort and understanding.
• Positioning: Proper positioning is crucial (more on this later). The patient should be correctly aligned to ensure the procedure is successful.
• Monitoring: Continuously monitor patients for any signs of distress or complications, such as changes in vital signs or discomfort levels.

Each action taken by the nurse is aimed at creating a supportive environment where procedures can be performed without risk. The importance of adhering to each step in a structured way ensures the safety of patients at a high standard.

Informed Consent in Nursing

Informed consent is a cornerstone of ethical nursing practice, especially in procedures like lumbar punctures. This legal and moral obligation ensures patients understand the procedure, its risks, and possible outcomes.
Getting informed consent involves several steps:

• Education: The nurse explains the procedure comprehensively, including potential risks, benefits, and alternatives. This empowers the patient to make an informed decision.
• Verification: Ensure the patient has understood the information. Nurses should use simple language and avoid medical jargon to enhance understanding.
• Documentation: Once the patient agrees, they must sign a consent form. This serves as legal proof that the patient has consciously agreed to proceed with the procedure.

Informed consent not only respects patient autonomy but also builds trust between the nurse and the patient, promoting a therapeutic relationship that facilitates cooperation and understanding.

Patient Positioning in Nursing

Patient positioning is a critical aspect of performing successful medical procedures. For a lumbar puncture, the patient's body must be positioned correctly to allow proper access and ensure their comfort and safety throughout the procedure.

• Correct Position: The recommended position for a lumbar puncture is the lateral recumbent position, where the patient lies on their side, knees drawn up to the chest, and neck flexed. This position opens up the spaces in the vertebrae.
• Maintaining Comfort: Properly support the patient with pillows and provide reassurance to keep them relaxed, reducing muscle tension which could otherwise complicate the process.
• Assistance: Nurses should assist in both positioning and maintaining the patient's position during the procedure to prevent movement that might lead to complications.

Positioning is integral not only for access to the required site but also to minimize procedural discomfort and reduce the risk of adverse outcomes. It highlights the nurse's role in ensuring a seamless experience during medical interventions.