Nursing Students General Students
Published Mar 18, 2005
raindrop
611 Posts
Is it push fluids or make sure they lay flat? Maybe neither of those are the *MOST* important?
I think that the most important thing to do is make sure they lie flat, b/c if they get up, the puncture could lose it's coagulation. My instructor, however, didn't really stress what is most important, and my classmates think it's most important to make sure they drink plenty of water, unless there is a fluid restriction on that patient.
My instructor just said "The doc will order how long they should lie flat for, and it's usually not very long. It helps prevent a bad headache. Make sure they get plenty of fluids in."
LadyK82
44 Posts
I would have to say lying flat and applying pressure to the area. I know fluids are important, but they can't drink fluids if they're bleeding to death. I know with a liver biopsy you have to lay on the right side and on our test it was the priority nursing action, so I'm assuming the same would be true of a spinal.
LPN_mn
138 Posts
I just recently had a spinal tap and in my opionion, as the patient, I would have to say lay flat. Mine was done in ER and was sent home within 1 hour after having procedure done. IMHO this was way to soon to be up because I had severe headaches for >1 week ended up having a patch done to get rid of the HA. Doctor stated if they had kept me laying flat for at least 3-4 hours I probably would not have had the HA. I told him I would rather be in labor then to deal with the intensity of those HA's.
mattsmom81
4,516 Posts
Prevention of leak is number one goal IMHO and that involves laying flat (1 hr is waay to soon to let someone up)asessment and care of the site. But...go by what your instructor says. :)
All_Smiles_RN
527 Posts
I'd say monitor for signs of infection.
ManyRN2B
317 Posts
Lay flat is very important. It's so the CSF can gain equilbrium back again. Fluid shift.....Something like that equilbrium may not be the right word. Like someone else said, spinal headache if not.
Joeknee
35 Posts
S&S of infection wouldn't set in until much later.
crb613, BSN, RN
1,632 Posts
I am with you lay flat!! I had a spinal tap done some time ago & the headache was horrible!! They did keep me flat but the vomiting & HA was soooo bad. I had the darn thing (HA) for a week or so bad, bad, bad. It would have to life/death before I would ever have it done again.
I remember! :roll the reason you lay on your back is so the fluid can replinsh. I said equalize........
I'm pretty sure that is why. The fluid has to rebuild.
mel82
70 Posts
I just had this question on a test yesterday and I put drink fluids. According to my NCLEX review book this is the answer.
HTH, Melanie
dianacs
431 Posts
I think it's laying flat so that the site stays intact.
athomas91
1,093 Posts
I would have to say lying flat and applying pressure to the area
what?!?!? pressure to the area doesn't help anything when the subarachnoid space has been entered (spinal tap)
and unfortunately especially if you are under the age of 50 your risk of spinal headache is increased even if you lay flat for 2 wks. It all depends on what type of needle they used to do the tap. IV fluids is a great thing for a nurse to give to one who has had this procedure. and laying flat for one hour is fine - then send them home and tell them to continue to lay down for a few more hours. other than that - there is nothing you can do. most spinal headaches (if true spinal headaches) are positional ie. they are relieved by laying down and worsened by standing. if intolerable - you should let your doctor know - or return to the ER and anesthesia can do a blood patch which fixes the problem.