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  • Before The Procedure: 1.using A Flowchart, Provide The Whole Procedure of Lumbar Tap

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    Colene Mores
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    MORES_MODULE 5

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    11 views2 pages

    Before The Procedure: 1.using A Flowchart, Provide The Whole Procedure of Lumbar Tap

    Uploaded by

    Colene Mores

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    MORES, MARY COLENE P.

    BSMT 2G
    MODULE 5 ENHANCEMENT QUESTIONS
    CEREBROSPINAL FLUID (CSF)
    1.Using a flowchart, provide the whole procedure of lumbar tap.

    LUMBAR TAP PROCEDURE

    Verify that no
    contraindications exist.This Explain the procedure to the
    Place the necessary orders
    BEFORE THE may include doing a CT patient and answer all
    so that the CSF tubes can be
    head to rule out active questions. Obtain informed
    PROCEDURE bleeding, midline shift, consent with appropriate
    labeled after the procedure
    is completed
    space-occupying lesions or documentation.
    signs of brain swelling.

    Wash hands, open the


    Position the patient either in Locate the L3/L4 space by
    lumbar puncture tray
    DURING THE lateral decubitus / fetal locating the superior iliac
    without compromising
    position, or sitting upright crests and placing your
    sterility and consider any PROCEDURE leaning forward over a thumbs midline to the
    extra supplies (i.e., spinal
    small table spine.
    needles or extra tubes)

    Finish setting the LP tray


    including opening the CSF Draw up and inject 10 mL of
    Aseptically clean the skin Put on sterile gloves,
    tubes in preparation to be 1% or 2% lidocaine
    using chlorhexidine skin facemask, and protective
    easily accessed, and apply (preservative free; without
    prep gear per institutional policy
    the sterile drapes to the epinephrine) to the area
    patient

    Insert the spinal needle The entry into the


    directed at a slight cephalad subarachnoid space is
    Attach the sterile
    angle and with the bevel of commonly described as Have the patient slowly
    manometer to the end of the
    the needle oriented to the feeling a "pop" sensation, stretch out legs (if lying in
    spinal needle to measure the
    longitudinal fibers to the needle insert (obturator) lateral decubitus)
    opening pressure
    separate the fibers instead of is then removed and CSF
    cutting them should begin to drip out

    Reinsert the needle insert


    Empty the manometer into
    (obturator) and withdraw
    CSF tube #1 and about 10 AFTER THE
    Measure the closing the spinal needle and
    drops of CSF into tubes #2 -
    4 (note: some institutions
    pressure (if indicated) immediately apply pressure PROCEDURE
    and an adhesive bandage
    use only 3 tubes)
    over the insertion site

    Document the procedure, Document the procedure,


    Immediately label the CSF
    Repeat neurologic number of attempts, number of attempts,
    tubes have the tubes hand
    assessment to evaluate for opening and closing opening and closing
    carried/delivered to the lab
    any changes post-LP pressure (if applicable), total pressure (if applicable), total
    for analysis
    amount of CSF drained amount of CSF drained
    2.In a tabular form, give the cause and clinical significance of the different colors/appearance of CSF.

    CSF COLOR CAUSE CLINICAL SIGNIFICANCE

    Normal
    CRYSTAL CLEAR

    White Blood Cells (WBCs)(over Meningitis


    HAZY, TURBID, MILKY,
    200 cells/µl)
    CLOUDY
    Microorganisms Meningitis
    (bacteria, fungi, amebas)
    Proteins Disorders that affect blood-brain
    barrier
    Production of IgG within the CNS
    Radiographic contrast media
    OILY

    Red Blood Cells (RBCs) Hemorrhage


    BLOODY
    Traumatic Tap
    Hemoglobin Old hemorrhage
    XANTHOCHROMIC
    Lysed dells from traumatic tap
    Bilirubin RBC degradation
    Elevated serum bilirubin level
    Carotene Increased serum levels
    Protein Disorders affecting blood-brain
    barrier
    Melanin Meningeal melanosarcoma

    REFERENCES

    https://www.ebmconsult.com/articles/procedure-lumbar-puncture

    https://slideplayer.com/slide/5846519/

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