Nokea
After discontinuing an indwelling urinary catheter, what should you assess for?
- A. Swelling and discharge from the urinary meatus
- B. Whether the patient has voided within 8 hours
- C. Temporary decrease in urine output
- D. Temporary urge incontinence
Correct Answer: B,D
Rationale: Assessing for voiding within 8 hours ensures the patient can urinate naturally, and temporary urge incontinence is common after catheter removal.
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You are teaching an aide to perform catheter care. Which of the following represents an accurate statement?
- A. Clean the perineum and a few inches of tubing using a perineal wash and a washcloth or gauze in downward strokes away from the body.
- B. Wash the perineum with a soapy washcloth using circular motions.
- C. Wash from the tubing 3 to 4 inches from the insertion site up toward the meatus.
- D. Separate the labia if the patient is female and wash first on one side, then the other, and then down the middle.
Correct Answer: A,D
Rationale: Cleaning downward from the meatus and separating the labia to clean thoroughly prevents infection by moving away from the insertion site.
Sometimes patients are not aware that they retain urine. If the residual urine volume is less than 300 mL and does not feel uncomfortable to the patient, is there any reason to try to correct the problem?
- A. Yes, because the enlarged bladder can cause pressure on other organs.
- B. Yes, because residual urine can lead to urinary tract infections.
- C. Yes, because it can cause enlarged prostate in men or urethral strictures in women.
- D. No, if the patient is not uncomfortable, a residual urine of 300 mL or bible does not require treatment.
Correct Answer: B
Rationale: Residual urine, even if asymptomatic, can increase the risk of urinary tract infections due to bacterial growth in stagnant urine.
You note that in the past 3 hours no urine has drained into your female patient's urinary collection bag. Which of the following is most likely responsible for this?
- A. Kinks in the tubing
- B. Acute renal failure
- C. Poor positioning of the drainage bag
- D. A kidney stone blocking the catheter
Correct Answer: A
Rationale: Kinks in the tubing are the most common cause of no urine flow, as they obstruct drainage.
Under what circumstances is it appropriate to use an indwelling catheter in a long-term care setting?
- A. If the patient has a stage I or stage II pressure ulcer
- B. If the patient has a stage III or stage IV pressure ulcer
- C. If the patient is continuously incontinent of urine and is at risk for pressure ulcers
- D. If the patient has a terminal illness
- E. If the patient has a severe impairment such that positioning and clothing changes are painful
Correct Answer: C,D,E
Rationale: Indwelling catheters are appropriate for severe incontinence risking pressure ulcers, terminal illness, or when positioning causes significant pain.
A straight-tipped catheter is best when catheterizing a patient with an enlarged prostate.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: A coude-tipped catheter is preferred for patients with an enlarged prostate to navigate the urethral curve.