The nurse is preparing a bladder irrigation for an adult client who has a long-term indwelling urinary catheter. The urine is cloudy with fibrin clots and sediment. Which intervention should the nurse implement?

Power flush with 60 mL to remove mucous obstructions.

Slowly irrigate catheter with saline using an infusion pump.

Clamp the catheter for 30 minutes prior to irrigating.

Use a sterile syringe to irrigate with 20 mL normal saline.

Answer and Explanation

The Correct Answer is B

A. Power flushing with 60 mL might be too forceful and could potentially damage the bladder or catheter. It is important to use a gentle approach to avoid complications.
B. Slowly irrigating the catheter with saline using an infusion pump is appropriate for gently clearing the clots and sediment while maintaining a controlled flow rate. This method is effective in managing obstructions and maintaining catheter patency.
C. Clamping the catheter before irrigation is not recommended as it could lead to increased bladder pressure and discomfort. The goal is to maintain urine flow and prevent complications from clots.
D. Using a sterile syringe to irrigate with 20 mL normal saline may not be sufficient to clear larger clots and sediment. A controlled, slower irrigation method using an infusion pump is generally preferred.

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Correct Answer is D

Explanation

A. Using firm pressure to pass the tube through the glottis can cause discomfort and potentially damage the client's airway. It is important to proceed with caution and avoid causing harm.
B. Tilting the head backward can actually make the insertion more difficult and increase the risk of gagging or aspiration. Proper head positioning typically involves slight flexion.
C. Giving the client sips of water is not recommended during NGT insertion as it can exacerbate gagging and increase the risk of aspiration.
D. Removing the tube and attempting reinsertion is the appropriate action if the client begins to gag. It allows the nurse to reposition the tube and attempt insertion more gently, ensuring the tube is correctly placed without causing undue discomfort or harm.

A. Include caregiver in discussion of pain relief strategies. B. Encourage the client to talk about her fear related to pain. C. Explain that analgesics will be given whenever needed. D. Provide therapeutic touch along with comfort and support.

Correct Answer is B

Explanation

A. Including the caregiver in discussions about pain relief strategies is important, but addressing the client’s immediate concerns and fears should come first.
B. Encouraging the client to talk about her fear related to pain allows the nurse to understand her specific concerns and provide personalized reassurance and support. Addressing the client’s emotional needs is crucial in hospice care.
C. Explaining that analgesics will be given as needed is important for reassurance but may not fully address the client’s fear or allow for an open discussion about her concerns.
D. Providing therapeutic touch and comfort is supportive but does not directly address the client’s fear. Engaging in a conversation about her specific fears allows for more targeted and effective reassurance.

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The nurse is preparing a bladder irrigation for an adult client who has a long-term indwelling urinary catheter. The urine is cloudy with fibrin clots and sediment. Which intervention should the nurse implement?

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Naxlex Comprehensive Predictor Exams

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