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Best Practices in Urinary Catheter Care

Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional: June 2010 - Volume 28 - Issue 6 - p 349–351
doi: 10.1097/NHH.0b013e3181e2ca8e
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Best Practices in Urinary Catheter Care


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GENERAL PURPOSE: To present registered professional nurses with current options for urinary catheterization and their associated complications, while providing approaches to the assessment and management of catheters in patients who have urinary dysfunction.

LEARNING OBJECTIVES: After reading this article and taking this test, you should be able to:

  1. Summarize the prevalence of, indications for, and complications of urinary catheterization.
  2. Plan the appropriate assessment of and care for patients who require bladder catheterization.

1. During the course of a year, about how many million Americans undergo urinary catheterization?

a. three

b. four

c. five

d. six

2. The prevalence of urinary catheter use among residents of long-term care facilities is estimated to be between

a. 7.5% and 10%.

b. 10.5% and 13%.

c. 13.5% and 16%.

d. 16.5% and 19%.

3. A common indication for intermittent catheterization is

a. monitoring the urine output of critically ill patients.

b. increasing comfort for terminally ill incontinent patients.

c. managing any skin damage caused by incontinence.

d. measuring residual urine volume.

4. A common indication for indwelling catheterization is

a. obtaining urine samples.

b. emptying the bladder.

c. maintaining a continuous outflow of urine for preoperative patients.

d. instilling contrast material into the bladder.

5. A common indication for suprapubic catheterization is

a. obtaining sterile urine specimens.

b. instilling medication directly into the bladder.

c. urethral or pelvic floor trauma.

d. immediate treatment of urinary retention.

6. The most common complication associated with urinary catheter use is

a. urinary stones.

b. trauma to the urethra or bladder.

c. accidental catheter dislodgement.

d. catheter-associated urinary tract infection (CAUTI).

7. About how many home health care patients develop CAUTI?

a. 3%

b. 8%

c. 13%

d. 18%

8. After 30 days of indwelling catheterization, bacteriuria is present in about what percentage of patients?

a. 70%

b. 80%

c. 90%

d. 100%

9. A biofilm is

a. a densely adherent structure that protects bacteria.

b. a dressing that protects the catheter insertion site.

c. the thin layer on the outside surface of a catheter.

d. the periurethral pathway through which bacteria ascend.

10. A discrepancy in intake and output volumes is likely to indicate

a. that the patient is not drinking enough fluid.

b. a mechanical problem with the catheter.

c. that the patient has developed CAUTI.

d. urine bypassing the bladder.

11. Excoriation of the urethral orifice is a sign of

a. urinary retention.

b. blockage of the catheter.

c. urinary incontinence.

d. leakage from the catheter.

12. A risk factor for developing CAUTI is

a. lack of antimicrobial exposure.

b. younger age.

c. previous catheterization.

d. male gender.

13. Which of the following is recommended for patients requiring indwelling catheterization?

a. using a catheter that is at least 18 Fr in diameter

b. cleansing the perineum only when it becomes soiled

c. making sure the catheter has a 30-mL balloon

d. securing the catheter to the thigh or abdomen after insertion

14. Which of the following is recommended to prevent catheter obstruction?

a. emptying the collection bag only when it is full

b. replacing the collection bag at routine, fixed intervals

c. positioning the collection bag below the level of the bladder

d. instilling antibiotics or other additives into the collection bag

15. In the home setting, intermittent catheterization should be performed

a. at regular intervals.

b. when the patient senses bladder fullness.

c. using sterile technique.

d. only when bladder volume exceeds 400 mL.

16. According to Dille and Kirchhoff, daily cleansing of both nighttime and leg drainage bags with which of the following solutions safely extended the use of the urinary drainage bags from one week to one month?

a. 3% hydrogen peroxide

b. distilled white vinegar

c. 1:10 household bleach solution

d. normal saline solution



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