PREPARING THE PATIENT BABY / CHILD
TO ACTION lumbar puncture (LP)
DEFINITIONS1. Preparing patients for lumbar puncture actions, so that the action can take place smoothly2. Lumbar puncture is a way to take the cerebro spinal fluid with a needle puncture on spine gap between L3 - L4 and the L4 - L5, with a view to measuring the liquor pressure and relieve pressure when necessary
PURPOSE1. The fear and anxiety of patients lost, so that the act of lumbar puncture can run smoothly2. Getting the examination materials to help establish the diagnosis
MADE IN PATIENTS WITH1. Seizures or "twitching"2. Coma of unknown cause3. Abnormalities in the crown - the crown of the prominent4. Stiff neck with a decreased awareness5. Miliary tuberculosis6. Leukemia7. Chronic mastoiditis (suspected meningitis)8. Paresis (paresis N VI)9. ParalysisPREPARATIONPreparation tools:1. Tray 1 contains the tools - sterile tools include:Gloves one to two pairs ofDuk single holeCotton sticksGauzeDry cottonMandrinnya lumbar needle complete with 2 piecesSyringes 2 cc and 5 ccManometer liquorA small bottle of cerebro spinal fluid where two2. Tray 2 contains a tool - a tool on sterile, among others:Iodine tincture 3% in its placeAlcohol 70% in its placeDrugs - drugs as neededTwo small bottles (each - each containing fluid Nonne and Pandy ± 1 ml)Ruler as a high-pressure gauge liquorPlasterScissors verbandCrookedPreparation of the patient:1. Giving meaning to the patient and family about the intent and purpose of the action and how to implement it, so that action can take place smoothly2. The position of the patient in accordance with the requirements setIMPLEMENTATION1. The patient is prepared, put down clothing to cover areas not L3 - L5 and dikeataskan clothes. In patients with a closed breech baby diaper area2. The position of the patient bed is tilted to the left or to the right, put his hands between her legs, then nurse bend the neck and knee, knee and chin almost meet3. Lumbar puncture performed by a physician4. Doctors wear gloves, then the area to be pierced disinfected with iodine, then with cotton alcohol, wait until dry5. At the time the doctor inserts a needle puncture, the patient's head is pressed and if the liquor is out, takanan removed, only the head was detained alone6. After the liquor out, nurses do: Measure liquor pressure Entering cerebro spinal fluid one to two drops into the tube Nonne and Pandy Holds liquor in small bottles for examination materials7. After the liquor that comes out is considered sufficient, revoke doctors needle puncture8. Former prick pressed by a stick of cotton iodized, then covered with gauze and plaster9. Bottles containing cerebro spinal fluid, placed in a safe place, to keep the liquid from spilling and labeled complete and clear (date of decision, the patient's name, ward, of tests needed) and then immediately sent to the laboratory10. Patients trimmed back11. Tools - tools cleaned, packed up and returned to the same spot
CAUTION1. Note and record the patient's general condition before, during and after the lumbar puncture performed actions2. In patients with effort, the head should not be suppressed, but the pull muscles - the muscles of the spine, when the doctor will put a needle puncture3. After lumbar puncture, the patient should sleep supine for 4-6 hours4. Things - things to note include:
- Colors liquor
- The number of liquor coming out
- Nonne da Pandy reaction against the liquor cerebro spinal
- Date carried out
5. Avoid infection of the puncture marks, especially in patients with frequent lumbar puncture