A nurse on a medical-surgical unit is planning care for a client who has dementia and a history of wandering. Which of the following actions should the nurse plan to implement?

Choice A reason: Instructing the client to expect tingling in their extremities is not a standard post-lumbar puncture care instruction. Tingling may be a sign of nerve irritation or damage, which is not an expected outcome and should be reported if it occurs.

Choice B reason: Measuring blood glucose every 2 hours is not related to post-lumbar puncture care unless the client has a specific condition that requires such monitoring. Post-lumbar puncture care focuses on preventing complications such as headaches and monitoring for signs of infection or bleeding.

Choice C reason: Limiting the client's fluid intake is not advised following a lumbar puncture. In fact, increasing fluid intake can help prevent the occurrence of post-lumbar puncture headaches, which are a common complication. Adequate hydration helps replenish cerebrospinal fluid and reduce headache severity.

Choice D reason: Instructing the client to lie flat is the correct action. After a lumbar puncture, it is recommended that the client lies flat for several hours to prevent the leakage of cerebrospinal fluid from the puncture site, which can lead to a spinal headache. Lying flat helps maintain normal cerebrospinal fluid pressure and reduces the risk of headache.

Choice A reason: Administering prednisone before the test may be part of a premedication protocol for clients with a history of allergic reactions to contrast media. However, this is typically done for iodinated contrast used in CT scans, not for gadolinium-based contrast agents used in MRA.

Choice B reason: Consulting with the provider to change to a CT scan would not be appropriate if the client is allergic to iodinated contrast dye, as CT scans commonly use iodinated contrast. MRA typically uses gadolinium-based contrast agents, which may be safer for clients with iodine allergies.

Choice C reason: Assessing the alkaline phosphatase level is not directly related to preparing a client with a contrast dye allergy for an MRA. Alkaline phosphatase is an enzyme measured in blood tests and is not specific to contrast media allergies.

Choice D reason: Obtaining the client's allergy history to seafood is not necessary for MRA preparation. While there is a common misconception that seafood allergies are related to iodinated contrast allergies, the evidence does not support this association.