A nurse is teaching a quality improvement course about decreasing the number of urinary tract infections for clients who have indwelling urinary catheters. Which of the following information should the nurse include in the teaching?

"Empty the drainage bag every 12 hours."

"Irrigate the indwelling urinary catheter once per shift."

"Apply a topical antimicrobial ointment as part of routine catheter care."

"Keep the drainage bag below the level of the bladder."

Answer and Explanation

The Correct Answer is D

A. "Empty the drainage bag every 12 hours.": Urine should be emptied regularly, but not on a fixed 12-hour schedule. The focus is on preventing backflow and maintaining sterility, so the bag should be emptied when it is two-thirds full or as needed, rather than strictly every 12 hours.

B. "Irrigate the indwelling urinary catheter once per shift.": Routine irrigation is not recommended for preventing catheter-associated urinary tract infections (CAUTIs) and can introduce pathogens or cause trauma. Irrigation should only be performed if specifically indicated for obstruction or provider order.

C. "Apply a topical antimicrobial ointment as part of routine catheter care.": Routine application of antimicrobial ointment is not recommended and does not prevent CAUTIs. Proper hygiene and sterile technique are more effective in infection prevention than topical agents.

D. "Keep the drainage bag below the level of the bladder.": Maintaining the drainage bag below the bladder prevents backflow of urine, which is a major risk factor for introducing bacteria into the urinary tract. This simple intervention is a key measure in reducing catheter-associated urinary tract infections.

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Correct Answer is C

Explanation

Rationale:

A. "Take the medication with an antacid if gastrointestinal upset occurs.": Antacids can bind to tetracycline and significantly reduce its absorption, making the antibiotic less effective. Clients should be instructed to avoid taking tetracycline simultaneously with antacids.

B. "Use a hormonal contraceptive when sexually active.": Tetracycline can decrease the effectiveness of hormonal contraceptives, so clients should use an additional form of contraception rather than relying solely on hormonal methods. This statement should emphasize using a backup method rather than suggesting hormonal contraceptives alone.

C. "Avoid taking this medication with milk.": Calcium-containing products, including milk, can bind to tetracycline and impair absorption. Clients should take the medication with water and separate it from dairy products by at least 2 hours to ensure effectiveness.

D. "Exposure to direct sunlight can help this medication improve acne.": Tetracycline increases photosensitivity, making clients more prone to sunburn. Clients should avoid direct sunlight and use protective measures such as sunscreen, hats, and protective clothing, rather than seeking sun exposure.

A. Insert a peripheral catheter to deliver intravenous fluids. B. Obtain a prescription for parenteral nutrition. C. Offer the client massage therapy: D. Initiate a referral for physical therapy.

Correct Answer is C

Explanation

A. Insert a peripheral catheter to deliver intravenous fluids: Routine IV fluid administration is not a standard intervention in hospice care unless specifically indicated for symptom management. The focus in hospice is on comfort and quality of life rather than aggressive interventions, so placing an IV line for routine hydration is generally avoided.

B. Obtain a prescription for parenteral nutrition: Parenteral nutrition is typically not initiated in hospice care because it does not improve comfort or quality of life and may cause discomfort or complications. Hospice care prioritizes symptom management, pain relief, and emotional support rather than aggressive nutritional interventions.

C. Offer the client massage therapy: Massage therapy is an appropriate intervention in hospice care as it promotes comfort, reduces pain, alleviates anxiety, and supports emotional well-being. Complementary therapies like massage are aligned with hospice goals of enhancing quality of life and providing holistic care for clients nearing the end of life.

D. Initiate a referral for physical therapy: Physical therapy in hospice is generally limited and focused only on maintaining comfort and safe mobility rather than improving function or strength. While referrals can be made if needed, massage therapy is a more direct intervention to address comfort and symptom management at this stage of care.

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A nurse is teaching a quality improvement course about decreasing the number of urinary tract infections for clients who have indwelling urinary catheters. Which of the following information should the nurse include in the teaching?

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