A client is having a lumbar puncture. In which position should the nurse place the client?
1. Lateral with head bent toward the chest and knees flexed onto the abdomen
2. Lying prone, with the knees drawn up toward the abdomen
3. Sitting bent over from the waist with legs extended
4. Supine with knees pulled toward the chest
ANSWER
Correct Answer: 1
Rationale 1: Lying in the lateral position with the head bent toward the chest and knees flexed onto the abdomen is the correct position for a lumbar puncture. In this position the back is arched, increasing the spaces between the vertebrae so that the spinal needle can be readily inserted.
Rationale 2: Lying prone with knees down toward the abdomen would position the client too high for the physician and could lead to increased intracranial pressure.
Rationale 3: Sitting would not arch the back enough to increase the space between the vertebrae for puncture.
Rationale 4: Supine with knees pulled toward the chest does not expose the vertebrae to be punctured.
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