A nurse is administering chemotherapy to a client with leukemia. Which of the following precautions should the nurse implement to ensure safety?

Choice A reason: Flushing the catheter system daily is not recommended for CAUTI prevention. It disrupts the closed system, increasing the risk of introducing pathogens into the bladder. Maintaining a sterile, closed drainage system is critical to prevent bacterial entry, and flushing is only indicated for specific blockages, not routine care.

Choice B reason: Obtaining a urine specimen for culture every 24 hours is not a preventive measure for CAUTI. Routine culturing is unnecessary unless infection is suspected, as it increases manipulation of the catheter system, risking contamination. Cultures are diagnostic, not preventive, and frequent sampling may introduce bacteria, counteracting infection control efforts.

Choice C reason: Securing the catheter prevents movement, reducing trauma to the urethra and bladder mucosa. Movement can cause microtears, allowing bacterial entry and colonization, leading to CAUTI. Proper anchoring ensures the catheter remains stable, minimizing irritation and maintaining the integrity of the urinary tract’s natural barriers against infection.

Choice D reason: Inspecting urine for color, odor, and consistency monitors for signs of infection but does not prevent CAUTI. Changes like cloudiness or foul odor indicate an existing infection, not prevention. While useful for early detection, it is a reactive measure, not a proactive intervention to reduce the incidence of catheter-related infections.

Choice E reason: Maintaining a closed drainage system is critical for CAUTI prevention. A closed system minimizes bacterial entry into the catheter and bladder by preventing disconnection or external contamination. Breaks in the system, such as during bag changes, increase infection risk, making this a key intervention to reduce pathogen introduction.

Choice A reason: Zidovudine, a nucleoside reverse transcriptase inhibitor, commonly causes bone marrow suppression, leading to anemia, neutropenia, or thrombocytopenia. It inhibits DNA synthesis in rapidly dividing bone marrow cells, reducing red blood cell, white blood cell, and platelet production. Monitoring complete blood counts is essential to detect these hematologic toxicities early and manage them appropriately.

Choice B reason: Metabolic alkalosis is not a known adverse effect of zidovudine. The drug primarily affects hematopoiesis and mitochondrial function, not acid-base balance. Metabolic alkalosis may occur in conditions like excessive vomiting or diuretic use, but zidovudine’s mechanism does not alter bicarbonate or pH levels, making this an unlikely complication.

Choice C reason: Hypoglycemia is not associated with zidovudine. The drug’s primary toxicities involve bone marrow and mitochondrial dysfunction, not glucose metabolism. Hypoglycemia may occur with other conditions or medications, like insulin, but zidovudine does not affect pancreatic function or glucose regulation, so monitoring for this is unnecessary in this context.

Choice D reason: Hyperkalemia is not a recognized side effect of zidovudine. The drug’s adverse effects center on hematologic and muscular systems, not electrolyte balance. Hyperkalemia may result from renal dysfunction or other medications, but zidovudine does not disrupt potassium homeostasis, so it is not a priority for monitoring in this patient.