Most important thing for a nurse to do after a spinal tap?

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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."

I'd like to add my experience with LPs. As a lot of you know I get migraines and earlier on I used to get them quite infrequently..and I would present in the ER with "the worst headache ever"....because they were! Well as you know that's the red flag for CT and LP especially with fever, which I coincidently had at the time. I thought my head hurt BEFORE the tap. Let me tell you! It was 2x as bad after. So my point is...if the pt comes in with headache and the doctor has already prescribed pain meds (NSAIDS or narcs..) please make sure the pt gets more meds after the procedure along with the fluid if he/she complains of worsening pain. Believe me. It happens. :nurse:

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