護理師照護一位剛完成腰椎穿刺的病人。為預防潛在併發症，下列哪項護理措施最優先？
A nurse is caring for a client who just had a lumbar puncture. Which action is the highest priority to prevent potential complications?
- AEncourage increased oral fluid intake鼓勵增加口服液體攝取量
- BAssess the puncture site for bleeding評估穿刺部位是否有出血
- CMonitor neurological status every 15 minutes每15分鐘監測神經狀態
- DMaintain a flat supine position✓ 正解維持平躺仰臥姿勢
腰椎穿刺後最常見併發症為腦脊髓液漏引起的頭痛。平躺姿勢能減少腦脊髓液壓力梯度，降低頭痛發生風險，是術後即刻護理的首要原則。鼓勵飲水與監測神經學狀態均屬後續護理重點，出血評估亦重要但姿勢控制對預防脊髓性頭痛更具關鍵性。
The most common complication after a lumbar puncture is post-dural puncture headache caused by leakage of cerebrospinal fluid. The flat supine position reduces the CSF pressure gradient and decreases the risk of headache, making it the priority of immediate post-procedure care. Encouraging fluid intake and monitoring neurologic status are also important subsequent measures, and although assessing for bleeding is necessary, positioning is more critical for preventing spinal headache.
台美臨床皆重視術後平躺，但美國對於平躺時間長度（1-4小時）的實證建議差異較大，台灣臨床多遵循醫師醫囑維持 4-6 小時。