Which of the following demonstrate that further teaching is required to prevent an infection related to being catheterized? (Select all that apply.) Show
a. An elderly female carries her urinary drainage bag like a purse under her arm as she ambulates. The urinary drainage bag should be kept below the level of the bladder to prevent reflux of urine into the bladder. Patients should be instructed to carry the drainage bag below the level of the bladder, and to secure the drainage bag to the side of the wheelchair below the level of the bladder during transfer. The urinary drainage bag should never be placed on a bedside rail because it could accidentally be raised to a height higher than the level of the bladder and urine could reflux into the bladder. The urinary drainage bag should never be placed on the floor; this is to avoid having bacteria enter the system through the drainage port. If allowed, fluids should be encouraged. The catheter should be secured to the patient to prevent trauma to the urethra. Swelling of tissues can impair urine flow and place the patient at further risk for urinary tract infection Which of the following are true regarding the impact of aging related to urinary elimination? (Select all that apply.) b.Aging can affect continence if the patient experiences impaired mobility or decreased muscle tone The very young and very old are less able to concentrate urine, placing them at risk for dehydration. The elderly are at an increased risk of urinary incontinence if they have impaired mobility that prevents them from getting to the bathroom in time or from manipulating buttons and zippers. Weak abdominal and pelvic floor muscles impair bladder contraction. Decreased muscle tone increases the risk for urinary incontinence. However, urinary incontinence is not a normal physiological result of the aging process. Urination frequency increases with age with decreased bladder tone. Because the bladder cannot contract as effectively, an older person often retains urine in the bladder after voiding (residual urine). This places the patient at increased risk for bacterial growth and development of UTIs. During change-of-shift report the nurse states that a patient has early renal failure and to be alert to this when administering medications. Why would this be a concern? The kidneys assist in the detoxification of medication metabolites. The kidneys detoxify and eliminate by products of medication metabolism. If the kidneys are unable to perform this function, medication toxicity can develop. The nephron, the functional unit of the kidney, forms the urine. The bladder holds the urine until it is excreted. The liver is a primary site for medication metabolism The nursing instructor is reviewing the renal system and urinary catheterization with her students. Which statement, if made by a nursing student, indicates that further instruction is needed? The nurse may use clean technique to insert an indwelling catheter. Sterile technique is used whether inserting a straight or indwelling urinary catheter. Patients may use clean insertion technique in the home setting for intermittent catheterization. When the patient is in an acute care or long-term care setting, sterile insertion technique is required because of the high risk for nosocomial infections. The urinary tract is sterile. The desire to urinate can be sensed when the bladder contains a smaller amount of urine (150 to 200 mL in an adult and 50 to 100 mL in a child). Minimum average hourly output is 30 mL. A 53-year-old patient is being treated for hypertension and a history of thrombophlebitis (blood clots). She comes to the clinic complaining, "I have to get up all night to go to the bathroom, and I think my urine looks orange!" What is the nurse's best
response? "What medications are you taking and when?" The nurse should first assess the patient's medication history before making any interpretation. The patient may be taking diuretics before going to bed or taking other medications that can change the urine's color. A 68-year-old female patient is admitted for knee replacement surgery with an expected hospital stay of 2 weeks. She has no known allergies. The health care provider has ordered an indwelling Foley catheter to be inserted preoperatively. Which catheter should the nurse choose? 14 French, 5-mL balloon, latex catheter A health care provider has ordered an indwelling catheter to be inserted to bedside drainage. Which of the following is NOT an expected indication
for Foley catheterization? To determine urinary retention A straight catheter or bladder scan may be used to determine urinary retention and would not be an indication for an indwelling catheter. Indications for an indwelling catheter include preparing for surgery, to obtain accurate output measurements, and for incontinent patients in which a wound needs to heal Obtaining a urine sample from an indwelling catheter requires sterile technique. True After a patient has had a Foley catheter for 1 week, a urine specimen may be obtained from the bedside drainage bag. False Obtaining a sterile urine sample for testing by using a
straight catheter can be delegated to NAP. False The nurse is collecting a sterile urine specimen for culture and sensitivity from the patient's indwelling Foley catheter. Choose the supplies necessary to carry out the procedure. (Select all that apply.) Clean gloves The supplies needed to collect a sterile urine specimen for culture and sensitivity include the following: clean gloves; an alcohol swab; a 5-mL Luer-Lok syringe to be attached to needle free port; a catheter clamp or elastic band; a sterile specimen container; a completed laboratory requisition; and an identification label. Although aseptic technique is followed, sterile gloves are unnecessary because a sterile syringe and needle are used to obtain the urine. The gloves are for personal protection from exposure to body fluids. A 20-mL syringe is used for routine urine studies. A towel/protective barrier, bedpan, soap, water, washcloth, towel, and sterile cotton balls are unnecessary for collecting a sterile urine specimen from an indwelling catheter. The nurse is informing the patient that the health care provider has ordered a urine test for culture and sensitivity that will be obtained from the
patient's indwelling Foley catheter. Which statement(s), if made by the patient, indicates that further instruction is needed? (Select all that apply.) b. "I think my catheter comes apart from the tubing that goes to the collection bag. We can take it apart and hold a cup at the end of the catheter until you get enough urine for the test." c. "After you clamp my tubing, I'm probably going to need some pain medication." d. "It won't hurt me when you get the urine." e. "The doctor is checking to see if I have a UTI." f. "You will have to insert a new catheter to get a sterile specimen." "That's okay; you can just get a sample out of my urinary drainage bag." "I think my catheter comes apart from the tubing that goes to the collection bag. We can take it apart and hold a cup at the end of the catheter until you get enough urine for the test." "You will have to insert a new catheter to get a sterile specimen." "After you clamp my tubing, I'm probably going to need some pain medication." What
is the recommended amount of time to leave the catheter clamped when obtaining a urine specimen from an indwelling catheter? 30 minutes
When obtaining a sterile urinary catheter specimen, the sterile specimen container should be opened and the lid: Placed with the inside up The sterile inside of the cap should be facing up to avoid contamination. It would be difficult to manipulate and obtain the midstream urine specimen if the lid were still on. Which of the following actions, if made by the nurse, could be considered negligence? Obtaining the urine specimen at 1030 and transporting it to the lab at 1115. Bacteria can multiply rapidly at room temperature. The specimen should be sent to the lab within 20 minutes or refrigerated for up to 2 hours. It is appropriate to clamp the drainage tubing below the catheter port for 30 minutes in order for urine to accumulate for collection. Aseptic technique should be used to prevent contamination of the specimen. At least 3 mL of urine is necessary to perform a urine culture. The cup should be labeled, not the lid to prevent errors related to incorrect identification. The nurse is reviewing urinary catheter care with a newly hired nursing assistive personnel (NAP). Which statement made by the NAP indicates further instruction is needed? "The bedside drainage bag should only be emptied when it is full." The fluid collection bag should be emptied when two-thirds full, or at least once every 8 hours. Clean technique is used to perform catheter care and sterile gloves are unnecessary. Moving the tape prevents the skin from becoming irritated. After reviewing the signs of infection, characteristics of normal urine, and the proper procedure, this task can be delegated to NAP and/or family members. The NAP documents "Peri-care given" next to "Urinary Catheter" on a patient with an indwelling urinary catheter. What is the best explanation of what the NAP did after application of
clean gloves? The NAP: b. stabilized the catheter and washed the catheter with soap and water from where the catheter enters the meatus down 4 inches toward the drainage tubing. c. inserted the hub of syringe into balloon port allowing the sterile water to return passively into the syringe and slid the catheter out into a waterproof pad. d. obtained a squirt bottle of warm water and had the patient squirt it over their perineum while sitting on the toilet. stabilized the catheter and washed the catheter with soap and water from where the catheter enters the meatus down 4 inches toward the drainage tubing. After routine perineal care is given with soap and water, the catheter is cleansed. While stabilizing catheter with dominant hand and using a clean washcloth, soap, and water, the catheter is cleaned in a circular motion along its length for about 10 cm (4 inches). Cleansing starts where the catheter enters the meatus and down toward the drainage tubing. The application of topical antimicrobial products is not effective in reducing meatal bacterial flora and reducing risk for UTI. Do not include them as a part of routine catheter care. Which of the following indicates a reason for notifying the health care provider to
get an order for removal of an indwelling catheter? The patient's urine appears cloudy with a foul odor. These are symptoms of a UTI. A UTI may be cause for an indwelling catheter to be removed. The health care provider should be notified as a sterile urine specimen may be ordered prior to removing the catheter. An indwelling catheter should be removed as soon as possible after insertion because of the risk for catheter-associated urinary tract infection (CAUTI). If the patient states that his bladder feels very full and is starting to hurt it may indicate that the tubing is kinked or the patient may be lying on the tubing preventing drainage. How long a catheter remains in place is determined by several factors, such as the type of material the catheter is made of, facility policy, reason for the catheter, and whether the patient is experiencing any complications. Often catheters intended for long-term use are changed once a month. Patients who are not drinking sufficient amounts of fluid should be encouraged to drink more. Remember to count IV solution in the fluid intake calculation. Identify the indicators of a UTI: (Select all that
apply.) Fever Fever is an indication of infection. Complaints of pain or burning are indicative of a UTI as urine passes over inflamed tissues. The patient may feel abdominal pressure and discomfort with a UTI. Urine should be clear; cloudy urine may indicate the presence of bacteria or white blood cells in the urine. Which of the following steps should you take before removing fluid from the balloon in a Foley catheter? (Select all that apply.) Attach a 10 mL or larger syringe to the balloon port and allow the water to passively fill the syringe. A 10 mL or larger syringe should be attached to the balloon port, and the water should be allowed to passively fill the syringe. Gentle aspiration, if necessary, is appropriate. A patient had an indwelling catheter for 3 weeks. The patient had the catheter removed 3 hours ago and now complains of having to go to the bathroom frequently and that it is painful to void. Which instruction is appropriate for the nurse to give the patient? This is a normal occurrence after having a catheter in place for more than several days." If the catheter was in place for more than several days, the patient may experience dysuria (painful voiding) resulting from inflammation of the urethral canal. Because of decreased bladder muscle tone, the patient may urinate frequently. These symptoms should subside with time. If a patient's indwelling catheter is removed at 0900, the patient should be due to void by: 1500 - 1700 (3:00 PM to 5:00 PM) The patient should be due to void in 6-8 hours, or by 3:00 to 5:00 PM. If the patient fails to void, nursing measures should be taken (i.e., assess for bladder fullness, provide privacy, assist to normal voiding position, run water). If unsuccessful, the health care provider should be notified. Which of the following is the best
example of documentation on a patient with a urinary catheter? Catheter care provided; no encrustation noted. Foley catheter patent and draining clear yellow urine to bedside drainage bag. Documentation should include the appearance of the urine whether clear or cloudy or with sediment and color. Does obtaining a urine sample from an indwelling catheter require sterile technique?The nurse will use sterile technique to obtain a urine specimen from an indwelling urinary catheter to ensure that any microorganisms in the specimen are from the urine, not from the patient's skin, the nurse's hands, or the environment.
Which method would be appropriate for collecting a sterile urine specimen from an indwelling catheter?Indwelling Catheter Urine Collection
Clean the catheter collection port with a 70% alcohol swab • Using sterile technique, puncture the collection port with a needle attached to a syringe • Aspirate the urine and place it into a sterile container. Do not use urine from collection bag.
What is the best technique for obtaining a sterile urine specimen from an indwelling urinary catheter quizlet?When collecting a urine specimen from an indwelling urinary catheter, which action is most likely to ensure that sufficient urine is collected? Rationale: Clamping the catheter tubing for 15 minutes before collection will ensure that sufficient urine is available for the specimen.
When obtaining a sterile urine specimen from an indwelling urinary catheter What should the nurse do?Clean the sample port of the catheter with an alcohol swab. Attach the Luer-lock syringe to the sample port of the catheter and withdraw 10-30 mL of urine; remove the syringe and unclamp the tubing. Open the lid of the sterile container, inverting the lid on the drape and maintaining sterility.
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Obtaining a urine sample from an indwelling catheter requires sterile technique Quizlet
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