When preparing to insert an indwelling urinary catheter, it is important to use the nursing process to plan and provide care to the patient. Begin by assessing the appropriateness of inserting an indwelling catheter according to CDC criteria as discussed in the “Preventing
CAUTI” section of this chapter. Determine if alternative measures can be used to facilitate elimination and address any concerns with the prescribing provider before proceeding with the provider order. In addition to verifying the appropriateness of the insertion of an indwelling catheter
according to CDC recommendations, it is also important to assess for any conditions that may interfere with the insertion of a urinary catheter when feasible. See suggested interview questions prior to inserting an indwelling catheter and their rationale in Table \(\PageIndex{1}\). For males: Do you have any history of prostate enlargement or prostate problems? For females: Have you had any gynecological surgeries? Cultural ConsiderationsWhen inserting urinary catheters, be aware of and respect cultural beliefs related to privacy, family involvement, and the request for a same-gender nurse. Inserting a urinary catheter requires visualization and manipulation of anatomical areas that are considered private by most patients. These procedures can cause emotional distress, especially if the patient has experienced any history of abuse or trauma. Objective AssessmentIn addition to performing a subjective assessment, there are several objective assessments to complete prior to insertion. See Table \(\PageIndex{2}\) for a list of objective assessments and their rationale.
Life Span ConsiderationsChildren Older Adults Expected Outcomes/Planning
Safety is a priority! Acquire additional staff assistance to help support and position patients who are weak, obese, frail, confused, uncooperative, or have a fractured hip or pelvis. ImplementationWhen inserting an indwelling urinary catheter, the expected finding is that the catheter is inserted accurately and without discomfort, and immediate flow of clear, yellow urine into the collection bag occurs. However, unexpected events and findings can occur. See Table \(\PageIndex{4}\) for examples of unexpected findings and suggested follow-up actions. Table \(\PageIndex{4}\): Unexpected Findings and Follow-Up Actions
EvaluationEvaluate the success of the expected outcomes established prior to the procedure. When obtaining a urine specimen from an indwelling urinary catheter How would the nurse clean the aspiration port?1)Cleanse the access port on the catheter with an antimicrobial swab. 2)Clamp or fold the catheter tubing below the access port. 3)Attach the syringe to the access port on the catheter using a twisting motion.
What should be included in the management of a patient with an indwelling urinary catheter?Daily catheter care should include:. Labeling on bag insertion date, time and place (e.g. OR, ER).. Maintain a closed urinary drainage system to prevent introduction of bacteria into the urinary tract.. Adequately secure and anchor the catheter to prevent urethral and bladder-neck tension.. What is nursing responsibilities in urinary catheterization?Caring for the Patient with an Indwelling Catheter
Be sure to wash hands before and after caring for a patient with an indwelling catheter. Clean the perineal area thoroughly, especially around the meatus, twice a day and after each bowel movement. This helps prevent organisms for entering the bladder.
How would the nurse obtain a urine C&S from an indwelling urinary catheter?Items within the kit:
Remove interlink cannula. Attach syringe to the blood (urine) transfer device. Insert UA tube into the barrel of the transfer device & obtain 10 ml of urine. Remove tube & repeat for C&S tube.
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