Page 2009 - Saunders Comprehensive Review For NCLEX-RN

3. Postprocedure interventions
a. The client may resume normal
activities.
b. Increase fluid intake and expect
diuresis if a contrast agent is used.
D. Lumbar puncture
1. Description
a. Insertion of a spinal needle through the
L3–L4 interspace into the lumbar
subarachnoid space to obtain CSF;
measure CSF fluid or pressure; or
instill air, dye, or medications
b. The test is contraindicated in clients
with increased intracranial pressure
(ICP), because the procedure will
cause a rapid decrease in pressure in
the CSF around the spinal cord,
leading to brain herniation.
2. Preprocedure interventions: Have the client empty the
bladder.
3. Interventions during the procedure

a. Position the client in a lateral

recumbent position and have the client
draw the knees up to the abdomen and
the chin onto the chest; the prone
position may be required for
radiologically guided punctures.
b. Assist with the collection of specimens
(label the specimens in sequence).
c. Maintain strict asepsis.
4. Postprocedure interventions
a. Monitor vital signs and neurological
signs to check for the presence of
leakage of CSF and also monitor for
headache.
b. Position the client flat as prescribed.

c. Encourage fluids to replace CSF

obtained from the specimen collection
or from leakage.
d. Monitor intake and output.
E. Cerebral angiography
1. Description: Injection of a contrast material usually
through the femoral artery (or another artery) into the
carotid arteries to visualize the cerebral arteries and
assess for lesions

2009