A nurse is inserting an indwelling urinary catheter for a female client.
In which order should the nurse perform the following steps? (Move the steps
into the box on the right, placing them in the order of performance.
Use all the steps.).

The correct answer is choice C. The client who says “I need to learn how to perform a dressing change on my leg” is indicating an acceptance of the limb loss and a readiness to learn self-care skills.

This is a positive sign of coping and adaptation after an amputation surgery.

Choice A is wrong because the client who says “I am going to have to find someone who can take care of my leg at home” is expressing dependency and denial of the limb loss.

The client needs to be encouraged to participate in self-care activities and rehabilitation.

Choice B is wrong because the client who says “I stay awake at night because I keep thinking about my leg” is experiencing phantom limb sensation, which is a common phenomenon after amputation.

The client may benefit from pain management, distraction techniques, and counseling.

Choice D is wrong because the client who says “I know my family means well, but I don’t want visitors seeing my leg right now” is showing signs of social isolation and low self-esteem.

The client needs emotional support and reassurance from the nurse and family members.

Normal ranges for vital signs after amputation are blood pressure 120/80 mm Hg, pulse 60-100 beats/min, respiratory rate 12-20 breaths/min, and temperature 36.5-37.5°C.

The nurse should remove the gloves first because they are the most contaminated piece of personal protective equipment (PPE) and should be discarded as soon as possible.

The nurse should then remove the gown, which may also be soiled with blood or body fluids, by grasping it at the neck and peeling it off inside out.

The mask and goggles should be removed last, by touching only the straps or earpieces, and avoiding touching the front of the mask or the lenses of the goggles.

Choice A is wrong because goggles are not the most contaminated piece of PPE and should be removed after the gown.

Choice B is wrong because gown is not the most contaminated piece of PPE and should be removed after the gloves.

Choice C is wrong because mask is not the most contaminated piece of PPE and should be removed after the gown and goggles.

Normal ranges for wound irrigation pressure are between 4 and 15 psi (pounds per square inch).

Higher pressures may damage the wound tissue and increase the risk of infection.

Lower pressures may not be effective in removing debris and bacteria from the wound.