The client has an indwelling catheter. How should the nurse ...

[Engineer]

The client has an indwelling catheter. How should the nurse obtain a sterile urine specimen?
 
  a. Disconnect the catheter from the drainage tubing.
  b. Withdraw urine from a urinometer.
  c. Open the drainage bag and remove urine.
  d. Use a needle to withdraw urine from the catheter port.

Question 2

Which one of the following actions should the nurse take in order to promote respiratory function in the immobilized patient?
 
  a. Change the patient's position every four to eight hours.
  b. Encourage deep breathing and coughing every hour.
  c. Use oxygen and nebulizer treatments regularly.
  d. Suction the patient every hour.

[ambernicolefink]

Answer to Question 1

D
A sterile specimen can be obtained through the special port found on the side of the in-dwelling catheter. The nurse clamps the tubing below the port, allowing fresh, uncontaminated urine to collect in the tube. After the nurse wipes the port with an anti-microbial swab, a sterile syringe needle is inserted, and at least 3 to 5 mL of urine is withdrawn. With sterile technique, the nurse transfers the urine to a sterile container.
The catheter should not be disconnected from the drainage tubing. The system should remain a closed system to prevent infection.
A urinometer is a device used to determine the specific gravity of urine. It is not a sterile device and should not be used for obtaining urine for a sterile urine specimen.
Urine should not be obtained from a drainage bag for a specimen, as the urine would not be fresh and would be contaminated from microorganisms in the drainage bag.

Answer to Question 2

B

Feedback
A The patient's position should be changed every two hours to reduce stagnation of secretions.
B The nurse should actively work with the immobilized patient to deep breathe and cough every one to two hours to promote chest expansion.
C The physician must order oxygen and nebulizer treatments. These interventions are used primarily to treat the patient who is experiencing an impaired air exchange, not to promote respiratory function in the immobilized patient.
D The patient should be suctioned as needed, not every hour.