A nurse is caring for a client in the medical-surgical unit.
Which of the following actions should the nurse take to decrease the risks for urinary tract infection for this client?
Select all that apply.
Review the need for the indwelling urinary catheter daily.
Place the drainage bag on the bed when transporting the client.
Use soap and water to provide perineal care.
Encourage the client to drink 3000 mL of fluid daily.
Change the indwelling urinary catheter tubing every 3 days.
Empty the drainage bag when it is half-full.
Correct Answer : A,C
A: Review the need for the indwelling urinary catheter daily.
This is correct because indwelling catheters should be removed as soon as possible to reduce the risk of urinary tract infection (UTI).
B: Place the drainage bag on the bed when transporting the client.
This is incorrect because the drainage bag should be kept below the level of the bladder and should not touch the floor to prevent the backflow of urine and contamination of the catheter.
C: Use soap and water to provide perineal care.
This is correct because soap and water can help to remove bacteria and debris from the meatus and prevent infection.
D: Encourage the client to drink 3000 mL of fluid daily.
This is incorrect because the client has a fluid restriction of 1000 mL daily due to heart failure. Excessive fluid intake can worsen the client’s condition and increase the workload of the heart.
E: Change the indwelling urinary catheter tubing every 3 days.
This is incorrect because changing the catheter tubing can increase the risk of infection by breaking the closed drainage system. The catheter tubing should only be changed when it is visibly soiled or malfunctioning.
F: Empty the drainage bag when it is half full.
This is incorrect because the drainage bag should be emptied at least every 8 hours or when it is one-third full to prevent back pressure and infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The leader allows the group to discuss whatever they would like to regarding their medications.
This is because a laissez-faire leadership style is characterized by minimal guidance and direction from the leader, and maximum freedom and autonomy for the followers.
The leader does not impose any rules or expectations on the group, and lets them decide how to manage their own learning and behavior.
Choice A is wrong because having group members vote on what they would like to learn about during the session is an example of a democratic leadership style, not a laissez-faire one.
A democratic leader solicits input and feedback from the group, and makes decisions based on consensus and majority rule.
Choice B is wrong because lecturing about medication adverse effects to the group members is an example of an authoritarian leadership style, not a laissez-faire one.
An authoritarian leader dictates what the group should do and how they should do it, without considering their opinions or preferences.
Choice D is wrong because encouraging group members to remain silent until questions are called for is an example of a paternalistic leadership style, not a laissez-faire one.
A paternalistic leader treats the group as if they are incapable of making their own decisions, and assumes a protective and nurturing role over them.
Normal ranges for leadership styles are not applicable in this context, as different styles may be more or less effective depending on the situation and the goals of the group.
However, some general advantages and disadvantages of each style are:
- Laissez-faire: Advantages - fosters creativity, independence, and self-motivation; Disadvantages - may lead to chaos, confusion, and lack of accountability.
- Democratic: Advantages - promotes participation, collaboration, and satisfaction; Disadvantages - may be time-consuming, inefficient, and conflict-prone.
- Authoritarian: Advantages - provides clarity, direction, and control; Disadvantages - may cause resentment, resistance, and dependency.
- Paternalistic: Advantages - creates trust, loyalty, and commitment; Disadvantages - may inhibit growth, development, and empowerment.
Correct Answer is D
Explanation
The correct first action for the charge nurse to take in response to an increase in facility-acquired catheter infections is toidentify possible precipitating factors related to the infections. This is because understanding the root cause of the problem is crucial before implementing any changes or interventions. By identifying the factors contributing to the increase in infections, the nurse can then develop targeted strategies to address these specific issues.
Now, let’s discuss why the other options are not the first actions to take:
-
Schedule nursing staff training for infection control procedures: While training is important, it should be based on identified needs. Without first understanding the precipitating factors of the increased infections, the training may not address the actual issues at hand.
-
Meet with providers to discuss measures to decrease the infections: This could be a subsequent step after identifying the precipitating factors. Meeting with providers without concrete data or understanding of the problem may lead to ineffective solutions.
-
Revise the current policy for catheter care: Policy revision should be based on evidence and identified needs. It would be premature to revise policies without first understanding what factors are contributing to the increase in infections.
In summary, the first step in addressing a problem is always to understand its causes. Only then can effective solutions be developed and implemented.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.