The nurse is caring for a preschool-age child recovering from a lumbar puncture. What should the nurse do to ensure the patient does not develop a spinal headache?
A) Measure temperature every hour.
B) Restrict fluids for 2 hours after the procedure.
C) Elevate the head of the bed to a 30-degree angle.
D) Take the pillow away and have the patient lie flat in bed.
D
Feedback:
A child may develop a headache after a lumbar puncture as a result of the reduction in CSF volume or invasion of a small air pocket during the puncture. The nurse should encourage the child to lie flat for at least 30 minutes. The child's blood pressure, pulse, and respirations should be assessed for changes that indicate an increase in intracranial pressure. The child should drink a glass of fluid after the procedure to help prevent cerebral irritation caused by air rising in the subarachnoid space and to help increase the amount of CSF. The head of the bed should be flat and not elevated to a 30-degree angle.
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