A nurse is caring for a client who has an indwelling catheter with a urinary drainage system. Which of the following actions should the nurse take?

Secure the tubing with adhesive tape to the lower abdomen.

Instruct the client to hold the drainage bag at waist height when ambulating

Coil the tubing on the bed above the collection bag.

Collect a sterile specimen from the urinary drainage bag

Answer and Explanation

The Correct Answer is A

A. Secure the tubing with adhesive tape to the lower abdomen: Properly securing the catheter tubing prevents tension on the catheter, reduces the risk of accidental dislodgment, and helps maintain a closed drainage system, which decreases the risk of infection.

B. Instruct the client to hold the drainage bag at waist height when ambulating: The drainage bag should always be kept below the level of the bladder to maintain proper urine flow and prevent backflow, which increases the risk of infection. Holding it at waist height is unsafe.

C. Coil the tubing on the bed above the collection bag: Placing tubing above the collection bag can allow urine to flow back toward the bladder, increasing the risk of urinary tract infection. Tubing should remain below bladder level.

D. Collect a sterile specimen from the urinary drainage bag: Sterile urine specimens should be obtained from a sampling port on the catheter using aseptic technique, not directly from the drainage bag, to avoid contamination.

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Correct Answer is A

Explanation

A. “Are you thinking of hurting yourself?”: This response directly and calmly assesses for suicidal ideation, which is essential when a client expresses feelings of worthlessness or passive death wishes. Asking clearly about self-harm allows the nurse to determine risk and initiate appropriate safety interventions.

B. “What would your family do without you?”: This response may increase guilt or emotional distress rather than encouraging open communication. It does not assess the client’s immediate safety or suicidal thoughts.

C. “When you get better you will not feel this way.”: This response minimizes the client’s current feelings and may make the client feel unheard or dismissed. It does not address potential suicidal risk or provide emotional support.

D. “Why would you think a thing like that?”: Asking “why” can sound judgmental and may discourage the client from sharing further. It does not assess for suicidal intent and may increase defensiveness or withdrawal.

A. Decreased hemoglobin level B. Increased weight of 0.91 kg (2 lb) C. Decreased BUN level D. Increased urinary output

Correct Answer is D

Explanation

A. Decreased hemoglobin level: A reduction in hemoglobin is not an expected effect of furosemide and may indicate anemia or another unrelated condition. It does not reflect the diuretic’s effectiveness in managing fluid overload.

B. Increased weight of 0.91 kg (2 lb): An increase in weight suggests fluid retention rather than loss. Effective furosemide therapy should result in stable or decreased weight as excess fluid is excreted. Monitoring weight helps assess fluid balance in heart failure patients.

C. Decreased BUN level: Changes in BUN are influenced by multiple factors including renal function, hydration, and protein intake. A decrease is not a reliable indicator of furosemide effectiveness in reducing fluid volume.

D. Increased urinary output: Furosemide is a loop diuretic that promotes excretion of sodium and water. An increase in urinary output indicates that the medication is effectively removing excess fluid, reducing edema, and alleviating symptoms of heart failure.

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A nurse is caring for a client who has an indwelling catheter with a urinary drainage system. Which of the following actions should the nurse take?

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