The nurse is assessing a patient with a urinary catheter.
Which of the following would be a priority nursing intervention?
Removing the catheter as soon as possible to prevent infection.
Ensuring that the catheter is properly secured to prevent accidental dislodgement.
Encouraging the patient to drink fluids to prevent dehydration.
Administering antibiotics to prevent infection.
Administering antibiotics to prevent infection.
The Correct Answer is A
This is because urinary catheters are a common source of catheter associated urinary tract infections (CAUTIs), which can lead to complications such as pyelonephritis, sepsis, and renal failure. Therefore, the nurse should remove the catheter as soon as possible to reduce the risk of infection and promote normal urinary function.
Choice B is wrong because ensuring that the catheter is properly secured to prevent accidental dislodgement is not a priority intervention for a patient with a urinary catheter.
While this is an important nursing action to prevent trauma and bleeding, it does not address the main complication of catheterization, which is infection.
Choice C is wrong because encouraging the patient to drink fluids to prevent dehydration is not a priority intervention for a patient with a urinary catheter.
While this is a good nursing practice to maintain hydration and renal perfusion, it does not affect the risk of infection associated with catheterization.
Choice D is wrong because administering antibiotics to prevent infection is not a priority intervention for a patient with a urinary catheter.
While this may be indicated for some patients who have signs and symptoms of UTI or who are at high risk of infection, it is not a routine measure for all patients with catheters and may contribute to antibiotic resistance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Clearance = urine flow rate x urine concentration / plasma concentration. This is the formula for calculating the renal clearance of a substance that is neither reabsorbed nor secreted by the tubules. Renal clearance is the volume of plasma that would have to be filtered by the glomeruli each minute to account for the amount of that substance appearing in the urine each minute.
Choice B is wrong because it has the urine concentration and plasma concentration inverted.
This would give an incorrect value for renal clearance.
Choice C is wrong because it has the plasma flow rate instead of the urine flow rate.
Plasma flow rate is not directly related to renal clearance.
Choice D is wrong because it has both the plasma flow rate and the urine concentration and plasma concentration inverted.
This would give an incorrect value for renal clearance.
Normal ranges for renal clearance vary depending on the substance, age, sex, and body size.
For example, the normal range for creatinine clearance is 85-125 mL/min for males and 75-115 mL/min for females.
Correct Answer is B
Explanation
Performing hand hygiene before and after handling the dialysis equipment is essential to prevent infection in peritoneal dialysis.
Hand washing and appropriate use of a mask can help avoid peritonitis, which is a serious complication of peritoneal dialysis.
Choice A is wrong because administering antibiotics prophylactically is not recommended for peritoneal dialysis patients, as it can increase the risk of antibiotic resistance and adverse effects.
Choice C is wrong because allowing the client to handle the dialysis equipment independently may increase the risk of contamination and infection.
The client should be supervised and instructed by a nurse on how to use sterile technique when connecting and disconnecting the transfer set.
Choice D is wrong because discontinuing the peritoneal dialysis if the client develops a fever may worsen the client’s condition and lead to fluid overload and electrolyte imbalance.
The client should be evaluated for signs of infection and treated accordingly.
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