The nurse is caring for a client with a prescription to ...

[wenmo]

The nurse is caring for a client with a prescription to discontinue the indwelling urinary catheter that has been in place for 2 weeks. Prior to removing the catheter, which action by the nurse is the most appropriate?
 
  1. Clamping the catheter for increasing periods to retrain the bladder to hold increasing amounts of urine before emptying
  2. Collecting urine to send for a culture and sensitivity
  3. Having the client cleanse the urethral meatus with soap and water
  4. Preparing a straight catheter for insertion if the client is unable to void after the indwelling catheter is removed

Question 2

The nurse is caring for a client with an indwelling catheter. When emptying the urine collection bag, the nurse notes the urine is cloudy with moderate amounts of sedimentation and a foul odor.
 
  Based on these assessment findings, what does the nurse suspect?
  1. Urethral irritation
  2. Bladder atrophy
  3. Urinary tract infection
  4. Kidney infection

[ndhahbi]

Answer to Question 1

Correct Answer: 1

The nurse would clamp the catheter for 1 hour, then allow the bladder to empty and clamp the catheter for 2 hours before draining, increasing the time to 4 hours to retrain the bladder. A urine culture would not be performed unless ordered by the health care provider. Cleansing the meatus should be done as routine catheter care, but would not be required prior to discontinuing the catheter. If straight catheterization were required due to inability to void, the catheter would be prepared prior to use, not prior to removing the indwelling catheter. Inability to void could not be determined for several hours after discontinuing the indwelling catheter.

Answer to Question 2

Correct Answer: 3

Cloudy, foul-smelling urine with sedimentation indicates a bladder infection. These findings should be reported to the health care provider, and an order for a urine culture would be anticipated. Bladder atrophy would be demonstrated by urinary incontinence or frequency. Urethral irritation would most likely present with hematuria. Further testing would be needed to suspect kidney infection, and a lower urinary tract infection would be more likely.