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
Choice A Rationale:
Hemorrhage is not a direct risk associated with antibiotic use and diarrhea. While severe diarrhea can lead to fluid loss and potentially hypovolemia, it's not the most significant risk in this context.
Antibiotics themselves don't typically cause bleeding issues unless they specifically interfere with clotting factors, which isn't common.
The nurse should monitor for signs of bleeding, but it's not the primary concern based on the patient's history of antibiotic use and diarrhea.
Choice B Rationale:
Cardiovascular collapse is a serious complication, but it's not directly linked to antibiotic use and diarrhea. It can occur due to various factors like severe dehydration, electrolyte imbalances, or underlying heart conditions. The nurse should be vigilant for signs of cardiovascular instability, but it's not the most likely risk in this scenario.
Choice C Rationale:
Electrolyte imbalances are a significant concern for patients with diarrhea, especially those on antibiotics. Antibiotics can disrupt the balance of gut bacteria, which play a crucial role in electrolyte absorption. Diarrhea further exacerbates electrolyte loss through fluid loss.
Key electrolytes to monitor include:
Potassium: Essential for nerve and muscle function, including the heart. Low potassium (hypokalemia) can lead to muscle weakness, fatigue, cramps, and potentially heart arrhythmias.
Sodium: Vital for fluid balance and nerve signaling. Low sodium (hyponatremia) can cause confusion, seizures, and coma.
Chloride: Also important for fluid balance and acid-base balance.
Magnesium: Crucial for muscle function, nerve transmission, and energy production. Low magnesium (hypomagnesemia) can cause muscle cramps, tremors, and heart arrhythmias.
The nurse should closely monitor the patient's electrolyte levels and watch for signs of imbalance, such as muscle weakness, fatigue, cramps, confusion, or heart rhythm abnormalities.
Choice D Rationale:
Respiratory paralysis is not a typical risk associated with antibiotic use or diarrhea.
It's more commonly linked to neuromuscular disorders, certain medications, or severe electrolyte imbalances (especially low potassium or calcium).
While the nurse should be aware of potential respiratory complications, it's not the most likely concern in this case.
Correct Answer is D
Explanation
Rationale for Choice A:
While it's true that a urinalysis can confirm the eradication of bacteria, it's not routinely recommended in uncomplicated UTIs when symptoms have resolved.
Conducting a urinalysis at this point could potentially lead to unnecessary healthcare visits and costs.
It's important to prioritize patient adherence to the full course of antibiotics, as this is the most effective way to prevent recurrence of infection.
Rationale for Choice B:
This response is inaccurate and could discourage the patient from completing the treatment.
It's essential for the nurse to convey that the treatment is likely working, even though the patient is feeling better. Reinforcing the importance of completing the full course of antibiotics is crucial for optimal outcomes. Rationale for Choice C:
Stopping the antibiotic prematurely, even if symptoms have improved, can lead to:
Increased risk of recurrent UTI
Development of antibiotic resistance
Prolonged or more severe infections in the future
Completing the full course of antibiotics ensures that all bacteria are eradicated, reducing the likelihood of these complications.
Rationale for Choice D:
This response correctly emphasizes the importance of completing the full course of antibiotics, even when symptoms have resolved.
It addresses the patient's concern while providing accurate and essential information.
Key points to highlight in this response include:
The need to eliminate all bacteria, including those that may not be causing active symptoms
The prevention of antibiotic resistance
The reduction of the risk of recurrent UTIs
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