Straight Catheter

Retention Catheter

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Coude Retention Catheter

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Balloon Inflation

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Balloon Inflation Port

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One of the greatest risks involved with urinary catheters

infection

perineal care or peri-care

Care of a patient with a urinary catheter

Perineal care involves cleansing around the

• catheter
• genitalia
• anus

Vital consideration when performing perineal care

• safety
• dignity
• privacy

Things to use when performing perineal care

• warm water
• basin
• washcloths
• gloves,
• approved perineal wash solution or soap

Do not use povidone-iodine, alcohol, or any other strong agent on the genital area.

Connector

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Urinary Collection Bag

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Drain Valve

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Leg Urinary Collection Bag

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Leg Straps

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Urinary Collection Cup

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A nurse us assessing a patient's indwelling urinary catheter drainage at the end of the shift and notes the output is considerably less than the fluid intake. Which of the following actions should the nurse take first?

1. Check the catheter for kinks.
2. Irrigate the catheter.
3. Palpate for bladder distention.
4. Assess for peripheral edema.

1. Check the catheter for kinks.

Output that is considerably less than intake is a sign that the catheter is blocked. The first action the nurse should take is to check the tubing for kinks and ensure the client's urine flow is not obstructed.

When providing perineal care for a female patient who has an indwelling urinary catheter, which of the following areas should the nurse cleanse last?

1. The perineum
2. The labia minora
3. The urethral meatus
4. The anus

1. The anus

The basic aseptic principle applicable to perineal care is to cleanse from the area of least contamination to the area that is the most contaminated. The anal area is typically contaminated with coliform bacteria and should be cleansed last.

Which of the following actions should a nurse take when removing a patient's indwelling urinary catheter?

1. Deflate the balloon completely before removal.
2. Make sure the patient has voided within 12 hr post removal.
3. Tell the patient to expect to feel a tugging sensation on removal.
4. Pull the catheter out as quickly as possible.

1. Deflate the balloon completely before removal.

If any inflation solution remains in the balloon, trauma to the urethral canal is likely with removal of the catheter.

A nurse is likely to receive an order for urinary catheterization of a new admitted patient who

1. has urge incontinence.
2. is in the ICU for a gastrointestinal bleed.
3. is incontinent due to cognitive decline.
4. has a persistent urinary tract infection.

1. is in the ICU for a gastrointestinal bleed.

Precise measurement of urinary output is crucial for managing fluid balance in patients who are critically ill.

A nurse is preparing to insert an indwelling urinary catheter for a female patient. When beginning the insertion procedure, the nurse should instruct the patient to

1. bear down.
2. hold her breath.
3. take deep breaths.
4. sip water.

1. bear down.

Bearing down as if to void relaxes the external sphincter and aids in the insertion procedure. This is the appropriate instruction for the patient.

A nurse who preparing to insert a straight urinary catheter for a male patient should

1. lift the penis to a 45° angle to the patient's body.
2. apply light traction to the penis.
3. grasp the penis at its base.
4. hold the penis parallel to the patient's body.

1. apply light traction to the penis.

Lifting the penis to a position perpendicular to the body while applying light traction straightens the urethral canal to facilitate catheter insertion.

A nurse is applying a condom catheter for an older adult patient who is uncircumcised. Which of the following is an appropriate step in the procedure?

1. Repositioning the foreskin after application
2. Stretching the catheter along the length of the penis
3. Leaving a space between the penis and catheter's tip
4. Securing the catheter with adhesive tape

1. Leaving a space between the penis and catheter's tip

A space of 2.5 to 5 cm (1 to 2 in) should be left between the tip of the penis and the end of the catheter. This space helps prevent irritation of the tip of the penis and allows full drainage of urine.

A nurse is planning on obtaining a urinary specimen from a patient's close urinary system. Identify the sequence of steps the nurse should take.

• Insert a 10 mL syringe and needle into the port.
• Withdraw 5 mL of urine.
• Transport specimen to the laborarory
• Transfer the urine to a sterile specimen container.
• Wipe the port with an alcohol swab.

1. Wipe port with alcohol swap
2. Insert a 10 mL syringe and needle into port.
3. Withdraw 5 mL of urine
4. Transfer the urine to a sterile specimen container
5. Transport the specimen to the lab