A nurse is reinforcing teaching with a client who has ovarian cancer and will receive chemotherapy through a peripherally inserted central catheter (PICC) line.
Which of the following statements by the client indicates an understanding of the teaching?

Choice A rationale

Securing the catheter tubing to the client’s thigh prevents unnecessary movement and minimizes the risk of catheter displacement or trauma, promoting urinary tract health.

Choice B rationale

Topical antimicrobial ointments are not routinely recommended for catheter care as they can promote microbial resistance or skin irritation without substantial benefit.

Choice C rationale

Clean technique is insufficient for collecting urine specimens from an indwelling catheter. Sterile technique is mandatory to prevent contamination and subsequent urinary tract infection.

Choice D rationale

Emptying the drainage bag every 12 hours is too infrequent. Urine should be drained regularly, typically every 6 to 8 hours or as needed, to prevent backflow or bacterial growth.

Answer and explanation

The correct answer is Choice A.

Choice A rationale

Inability to remain fully awake after head trauma indicates decreased neurological function, a sign of intracranial injury or bleeding, requiring immediate attention. Reduced consciousness compromises airway protection and perfusion. Normal intracranial pressure ranges from 7 to 15 mmHg in adults; elevated levels can indicate pathology. This finding is critical for prioritization to prevent irreversible brain damage.

Choice B rationale

Difficulty repeating named objects suggests short-term memory loss, often linked to conditions like concussion. However, it does not pose an immediate life threat like compromised consciousness does. Neurological evaluation is necessary but secondary in priority unless paired with other severe symptoms like loss of consciousness or seizures.

Choice C rationale

Failure to recall adult children’s names suggests long-term memory impairment. While it may indicate brain injury or dementia exacerbation, it is not an immediate threat compared to decreased alertness. Cognitive decline should be addressed later after stabilizing potential life-threatening conditions.

Choice D rationale

Errors in judgment tasks reflect possible frontal lobe dysfunction or cognitive impairment. Though concerning, this is not the most urgent finding unless associated with symptoms like increased intracranial pressure or stroke. Addressing primary life-sustaining functions remains the priority.