The physician has ordered an indwelling urinary catheter for a ...

[Davideckstein7]

The physician has ordered an indwelling urinary catheter for a client with urinary retention. The nurse practices strict aseptic technique when inserting an indwelling urinary catheter to prevent infection along with which of the following?
 
  1. Inflates a balloon while the catheter is in the urethra
   2. Instructs client not to void around the catheter
   3. Irrigates the catheter with sterile saline on a daily basis
   4. Uses an anesthetic lubricating gel during insertion

Question 2

The nurse is caring for the client experiencing hypovolemic shock and metabolic acidosis. Which of the following therapies would the nurse question if planned for this client?
 
  1. Administration of sodium bicarbonate
   2. Monitor ECG for conduction problems
   3. Monitor daily weights
   4. Limit the intake of fluids

[epscape]

Answer to Question 1

4. Uses an anesthetic lubricating gel during insertion

Rationale:
Unless contraindicated, the additional step of using an anesthetic lubricating gel promotes comfort and protects fragile urethral tissues from trauma, and therefore reduces risk for a catheter-associated UTI. The balloon is not inflated until the catheter is in the bladder, in order to prevent trauma to the urethra and therefore decrease the risk of infection. Although voiding around the catheter will decrease bladder spasms, it will not help reduce infection. Irrigating the catheter should not be done because it can introduce infection by allowing bacteria to enter the closed urinary drainage system.

Answer to Question 2

4. Limit the intake of fluids

Rationale:
The treatment for hypovolemic shock would include the administration of fluids, not limiting fluids. Administering sodium bicarbonate and monitoring daily weights and ECGs are all appropriate for the client with shock.

[Davideckstein7]

Thanks for the timely response, appreciate it

[juliaf]

Wow, this really help