A client with urine retention due to a complete prostatic obstruction requires a urinary catheter to drain the bladder. Which type of urinary catheter is most suitable for a client with an obstructed urethra?
Straight catheter.
Indwelling urethral catheter.
Intermittent urethral catheter.
Suprapubic catheter.
The Correct Answer is D
Choice A rationale:
Straight catheters are single-use catheters that are inserted into the bladder to drain urine and then immediately removed. They are not suitable for long-term use in clients with obstructed urethras because they would need to be inserted repeatedly, causing discomfort and potential trauma to the urethral tissues. Additionally, the obstruction itself would make it difficult or impossible to insert a straight catheter.
Choice B rationale:
Indwelling urethral catheters, also known as Foley catheters, are inserted into the bladder and remain in place for a period of time. They are typically used for clients who cannot void on their own or who require continuous bladder drainage. However, they are not the best option for clients with obstructed urethras for the following reasons:
The presence of the catheter within the urethra can further irritate or damage the already obstructed tissues. The balloon that holds the catheter in place could potentially worsen the obstruction.
The risk of urinary tract infections (UTIs) is increased with indwelling catheters.
Choice C rationale:
Intermittent urethral catheters are inserted into the bladder to drain urine and then removed. They are typically used by clients who can self-catheterize several times a day. However, they are not suitable for clients with complete prostatic obstruction, as the obstruction would make it difficult or impossible to insert the catheter.
Choice D rationale:
Suprapubic catheters are inserted directly into the bladder through a small incision in the abdomen, bypassing the urethra entirely. This makes them the most suitable option for clients with obstructed urethras, as it eliminates the need to pass a catheter through the obstructed area. Suprapubic catheters offer several advantages in this situation:
They avoid further irritation or damage to the urethral tissues.
They provide a more comfortable and convenient option for long-term bladder drainage.
They may reduce the risk of UTIs compared to indwelling urethral catheters.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale for Choice A:
Sims' position is a side-lying position with the lower arm and leg flexed and the upper arm and leg extended. It is not ideal for bladder scanning because it can displace the bladder and potentially lead to inaccurate readings. While it can be used for other purposes, such as inserting rectal suppositories or performing vaginal exams, it's not the optimal choice for bladder scanning.
Rationale for Choice B:
Dorsal recumbent position is a supine position with the knees bent and feet flat on the bed. While it provides some exposure of the bladder, it may not fully visualize the entire bladder due to potential compression from the abdominal contents. This can also result in inaccurate readings.
Rationale for Choice D:
High Fowler's position is a semi-sitting position with the head of the bed elevated at a 45- to 60-degree angle. This position is not suitable for bladder scanning because it can cause the bladder to shift upward and out of the optimal scanning range. It's typically used for respiratory comfort and procedures involving the head and upper body.
Rationale for Choice C:
Supine position is the best position for bladder scanning because it allows for the most accurate visualization of the bladder. In this position, the patient lies flat on their back with their legs extended. This position allows the bladder to rest naturally in the pelvic cavity, ensuring optimal positioning for the bladder scanner to capture a clear image and provide an accurate measurement of bladder volume. It also promotes patient comfort and relaxation during the procedure.
Correct Answer is B
Explanation
Choice A rationale:
Sims' position is a side-lying position with the lower leg flexed and the upper leg extended. It is not ideal for bladder scanning because it can compress the bladder and make it difficult to obtain an accurate reading.
Additionally, in Sims' position, the bladder may not be fully accessible to the scanner, as it may be partially obscured by the upper thigh.
Choice B rationale:
Dorsal recumbent position is the optimal position for bladder scanning. In this position, the client lies flat on their back with their knees bent and their feet flat on the bed. This position allows for:
Full exposure of the bladder, making it easily accessible to the scanner.
Relaxation of the abdominal muscles, which can help to ensure an accurate reading.
A comfortable position for the client, promoting cooperation and reducing the likelihood of movement that could interfere with the scan.
Choice C rationale:
Supine position is a similar position to dorsal recumbent, but with the legs fully extended. While it is possible to perform a bladder scan in this position, it is not as ideal as dorsal recumbent because:
The extended legs can place some tension on the abdominal muscles, potentially affecting bladder position and the scan's accuracy.
The client may find this position less comfortable, leading to restlessness and potential movement that could interfere with the scan.
Choice D rationale:
High Fowler's position is a semi-sitting position with the head of the bed elevated at a 45- to 60-degree angle. This position is not suitable for bladder scanning because:
Gravity can pull the bladder downwards, making it difficult to visualize and measure accurately.
It can be challenging to maintain proper positioning of the scanner on the abdomen in this position, potentially leading to inaccurate readings.
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