NURSING SCIENCE 3 (MKJ 2123)

MOHAMAD RAIS BIN MOHD SHUHAIMI

SP51213039
 A lumbar puncture (LP), also known as
a spinal tap, is a medical procedure in which
a needle is inserted into the spine, most
commonly to collect cerebrospinal fluid (CSF)
for diagnostic testing.
 Lumbar puncture should be performed for
the following indications:
Suspicion of meningitis
Suspicion of subarachnoid hemorrhage (SAH)
Suspicion of central nervous system (CNS)
diseases such as Guillain-Barr syndrome and
carcinomatous meningitis.
 Wearing nonsterile gloves, locate the L3-L4
interspace by palpating the right and left
posterior superior iliac crests and moving the
fingers medially toward the spine.
Open the spinal tray, change to sterile gloves,
and prepare the equipment.
Assemble the stopcock on the manometer,
and draw the lidocaine into the 10-mL
syringe.
 Use the skin swabs and antiseptic solution to
clean the skin in a circular fashion, starting at
the L3-L4 interspace and moving outward to
include at least 1 interspace above and 1
below.
Insert the needle at a slightly cephalad angle,
directing it toward the umbilicus. Advance the
needle slowly but smoothly. Occasionally, a
characteristic pop is felt when the needle
penetrates the dura.
 Collect at least 10 drops of cerebrospinal
fluid (CSF) in each of the 4 plastic tubes,
starting with tube 1.
Replace the stylet, and remove the needle.
Clean off the skin preparation solution. Apply
a sterile dressing, and place the patient in the
supine position.
 Age >65
Recent history of seizure
Abnormal respiratory pattern
Hypertension with bradycardia and
deteriorating consciousness
 If a patient develops headache after lumbar
puncture with characteristic features, they
should be encouraged to lie in a comfortable
position, which is mostly in the supine
position owing to the postural nature of the
symptoms. Supporting treatment such as
rehydration, simple analgesics, opioids and
antiemetics may control the symptoms in
milder cases.
 Postspinal puncture headache
Bloody tap
Infection
Hemorrhage
Dysesthesia
Postdural puncture cerebral herniation