Identify this instrument.

MP CHO -2021 (Shift 1st)

Medical Surgical Nursing

Easy

Appeared in: MP CHO -2021 (Shift 1st)

Explanation

The instrument in the image is a Lumbar Puncture (Spinal) Needle, used to access the subarachnoid space.
The defining feature, clearly visible, is the combination of a hollow outer cannula and a removable inner stylet.
The stylet's function is crucial: it prevents skin and tissue from being cored and introduced into the spinal canal, which could cause complications.
The presence of multiple needles of varying lengths is common in a lumbar puncture tray to accommodate different patient sizes.

Option A: An I.V. cannula consists of a flexible plastic catheter over a needle. The instrument shown is a rigid metal needle with an inner stylet, not a flexible catheter.
Option B: A vessel dilator is a blunt, tapered plastic device used to widen an opening in tissue or a vessel. It is not a sharp, hollow needle and does not have a stylet.
Option D: 'Long Needle' is a non-specific, generic term. While the instrument is a long needle, 'Lumbar Puncture Needle' is the precise medical name for this specific device which includes a stylet for a specialized purpose.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of specialized medical instruments as background academic context rather than a clinical decision trigger.
A nurse's primary roles during a lumbar puncture include correctly positioning the patient (fetal or sitting position), maintaining sterility, providing comfort, labeling CSF specimen tubes correctly, and monitoring the patient post-procedure.
Post-procedure monitoring is critical for detecting complications like a post-dural puncture headache (PDPH), bleeding, or signs of infection. Instructing the patient to remain flat helps reduce CSF leakage and the risk of PDPH.
What if the patient complains of a severe, throbbing headache that worsens when they sit up after the procedure? This is a classic sign of a post-dural puncture headache. The nurse should instruct the patient to lie flat, encourage hydration, administer analgesics as ordered, and notify the provider, as a blood patch may be required.

How to Approach the Question

First, carefully examine the image, paying close attention to the unique features of the instrument shown.
Identify the key components: a long, thin needle and a removable inner part (stylet). Note that there are several of these instruments of different sizes.
Consider the function of these components. A needle with a stylet is designed for a specific purpose: to pass through tissues without collecting a core of tissue.
Evaluate the given options based on your visual analysis.
Eliminate 'I.V. Cannula' as it is a flexible plastic tube, and 'Vessel Dilator' as it is a blunt, tapered rod.
Choose 'Lumbar Puncture Needle' over the generic 'Long Needle' because it is the specific medical term for a needle with a stylet used for this purpose.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1363-1365

E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 69-71