NURS 5355 Module 3 Asepsis and LP & NURS 5355 Clinical
Practice 2, Module 1, NP UTA
NURS 5355 Module 3 Asepsis and LP
Describe appropriate procedure for gowning and gloving - ANSWER 1. Gather
equipment that is required
2. Clean trolley surface (from top down)
3. Hand washing--social handwash
4. Surgical mask
5. Place the gown pack on the trolley and open the outer wrapping to reveal the
contents of the pack. Avoid touching the contents of the pack and the inner sterile
surface. Do not lean over sterile area.
6. Standing away from sterile field, peel open glove packaging, keep inside sterile. Tip
the inner packet onto sterile field.
7. ensure correct protective attire
Determine the contraindications to performing an LP - ANSWER Absolute CI--infection in
the tissue close to the puncture site
Relative CI--Increased ICP, (increase possibility of brain herniation) CT should be done
prior, thrombocytopenia or coagulopathies.
Describe the procedure for conducting a lumbar puncture - ANSWER 1. Locate
interspaces and mark site of puncture at the L4-5 interspaces in a perpendicular line
from the iliac crest. The L3-4 interspace above this level may also be used.
2. Put on hat, mask, sterile gown, and sterile gloves. Open prepared LP tray.
3. Using sponge applicator provided in LP tray, prepare the back with Chlorhexadine
solution, beginning at the site marked for the needle puncture and working outward.
Repeat twice.
4. Drape the patient
5. Recheck the landmarks
6. Infiltrate the skin and subcutaneous tissue with preservative free 1% lidocaine with a
, 22-25-gauge needle.
7. Insert the spinal needle into the midline of the interspace with bevel up. Direct the
needle on a 10-degree angle toward the umbilicus (horizontal axis).
8. Advance the needle slowly, removing the stylet every 2-3 millimeters to check for CSF
flow. If the patient complains of nerve root pain, do not advance the needle. Withdraw 2
millimeters, remove stylet and check for CSF. If none then replace the stylet and
remove. To subcutaneous tissue, remove the needle, change angle and continue. If
repeated bony resistance is noted, then the needle should be discarded and replaced. If
blood is returned, watch for clearing of fluid; if no clearing, replace the stylet, remove
the needle and notify the attending MD.
9. Once CSF flow is established, rotate the needle 90 degrees counter-clock wise (bevel
in transverse plane) for patients in the lateral decubitus position. If the patient is in the
sitting position no adjustment is needed. (Needle should always enter with the bevel in
the sagittal plane and be rotated to the axial plane, regardless of patient position)
10. Aspirate 1-2ml of CSF in each of the four tubes.
11. Laboratory samples are sent to collect data on glucose, protein, cell count and its
culture and gram staining or any other test, and cytology tests if appropriate.
12. For pa
What is required in an asepsis technique? - ANSWER Barriers, patient equipment and
prep, environmental controls, and contact guidelines
Some of the barriers used in aseptic technique include: sterile gloves and gowns, mask
for pt and providers, sterile drapes.
Hand hygiene.
What clinical conditions require asepsis technique? - ANSWER Surgery
biopsies
dressing surgical wounds or burns
suturing wounds
foley cath, wound drain, IV line, chest tube
administering injections
Vaginal exam
Practice 2, Module 1, NP UTA
NURS 5355 Module 3 Asepsis and LP
Describe appropriate procedure for gowning and gloving - ANSWER 1. Gather
equipment that is required
2. Clean trolley surface (from top down)
3. Hand washing--social handwash
4. Surgical mask
5. Place the gown pack on the trolley and open the outer wrapping to reveal the
contents of the pack. Avoid touching the contents of the pack and the inner sterile
surface. Do not lean over sterile area.
6. Standing away from sterile field, peel open glove packaging, keep inside sterile. Tip
the inner packet onto sterile field.
7. ensure correct protective attire
Determine the contraindications to performing an LP - ANSWER Absolute CI--infection in
the tissue close to the puncture site
Relative CI--Increased ICP, (increase possibility of brain herniation) CT should be done
prior, thrombocytopenia or coagulopathies.
Describe the procedure for conducting a lumbar puncture - ANSWER 1. Locate
interspaces and mark site of puncture at the L4-5 interspaces in a perpendicular line
from the iliac crest. The L3-4 interspace above this level may also be used.
2. Put on hat, mask, sterile gown, and sterile gloves. Open prepared LP tray.
3. Using sponge applicator provided in LP tray, prepare the back with Chlorhexadine
solution, beginning at the site marked for the needle puncture and working outward.
Repeat twice.
4. Drape the patient
5. Recheck the landmarks
6. Infiltrate the skin and subcutaneous tissue with preservative free 1% lidocaine with a
, 22-25-gauge needle.
7. Insert the spinal needle into the midline of the interspace with bevel up. Direct the
needle on a 10-degree angle toward the umbilicus (horizontal axis).
8. Advance the needle slowly, removing the stylet every 2-3 millimeters to check for CSF
flow. If the patient complains of nerve root pain, do not advance the needle. Withdraw 2
millimeters, remove stylet and check for CSF. If none then replace the stylet and
remove. To subcutaneous tissue, remove the needle, change angle and continue. If
repeated bony resistance is noted, then the needle should be discarded and replaced. If
blood is returned, watch for clearing of fluid; if no clearing, replace the stylet, remove
the needle and notify the attending MD.
9. Once CSF flow is established, rotate the needle 90 degrees counter-clock wise (bevel
in transverse plane) for patients in the lateral decubitus position. If the patient is in the
sitting position no adjustment is needed. (Needle should always enter with the bevel in
the sagittal plane and be rotated to the axial plane, regardless of patient position)
10. Aspirate 1-2ml of CSF in each of the four tubes.
11. Laboratory samples are sent to collect data on glucose, protein, cell count and its
culture and gram staining or any other test, and cytology tests if appropriate.
12. For pa
What is required in an asepsis technique? - ANSWER Barriers, patient equipment and
prep, environmental controls, and contact guidelines
Some of the barriers used in aseptic technique include: sterile gloves and gowns, mask
for pt and providers, sterile drapes.
Hand hygiene.
What clinical conditions require asepsis technique? - ANSWER Surgery
biopsies
dressing surgical wounds or burns
suturing wounds
foley cath, wound drain, IV line, chest tube
administering injections
Vaginal exam
