Priority with Lumbar Puncture

[emlam]

A group of classmates and I are having a debate on what is the nursing assessment highest priority after a patient with bacterial meningitis having a lumbar puncture done. Assuming the CT scan displayed no obstruction.

1. blood pressure

2. urine output

3. puncture site care

4. headache

Many believe the headache is the highest priority because the LP can produce headache intensity.

Some believe b/p because of the meningitis and cushing's triad.

[hodgieRN]

I think headache is probably the lowest priority. It's a symptom. You have to address pain, but blood pressure and circulation is far more important. Pts with meningitis can become septic, and that triumphs over a headache. Urine output is important in meningitis because septic pt are at risk for renal failure. Puncture site is also important, but it depends if it is talking about assessing the site for bleeding. If LP sites bleed or leak, that can cause pressure changes in your CSF. Since there is no obstruction, headache is the last priority.

[emlam]

So, my classmate is correct with her b/p as the highest priority then? I was thinking about the puncture site as a choice but could not find a rationale from my text to back up the choice.

[abeaty]

Studying this right now too. I would go with BP, remember your ABC's always come first as priority for post op/post procedure.

[Esme12, ASN, BSN, RN]

How about the puncture site for leakage of CSF........don't over think the question.