A student nurse is performing a urinary catheterization for the first time and inadvertently contaminates the catheter by touching the bed linens. What should the nurse do to maintain surgical asepsis for this procedure?
Complete the procedure and then report what happened.
Apologize to the client and continue on with the procedure.
Nothing because the client is on antibiotics.
Gather new sterile supplies and start the procedure over.
The Correct Answer is D
The correct answer is choice D. Gather new sterile supplies and start the procedure over.
In order to maintain surgical asepsis during a urinary catheterization procedure, the nurse must ensure that all equipment used is sterile and that there is no contamination of the equipment during the procedure. If the catheter is contaminated, the nurse should stop the procedure, gather new sterile supplies, and start the procedure over to prevent the introduction of bacteria into the urinary tract. Reporting the incident and apologizing to the client are important, but not the first priority in maintaining surgical asepsis. The fact that the client is on antibiotics does not change the need for sterile technique during the procedure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Upon discovering that the client's abdominal wound has been eviscerated, the nurse should immediately cover the wound area with sterile gauze moistened with sterile 0.9% normal saline. This will help to protect the exposed organs and prevent them from becoming dry or exposed to contaminants. Pouring hydrogen peroxide into the abdominal cavity can cause further damage to the exposed organs and is not recommended. Similarly, normal saline should be gently poured on the area to moisten it, but organs should not be placed back into the cavity as this can cause further injury. Attempting to close the wound area with reinforced adhesive skin closures is also not appropriate as the wound needs to be assessed and repaired by a healthcare provider. The nurse should call the healthcare provider and provide ongoing assessment and support to the client while waiting for further interventions.
Correct Answer is C
Explanation
The correct answer is choice C, Place all 4 side rails up to prevent the patient from getting out of bed and falling.
When considering alternatives to restraints for a confused and agitated patient who is at high risk for falls, placing all 4 side rails up to prevent the patient from getting out of bed and falling is not an appropriate alternative. This action can be considered as restraint use and can increase the patient's agitation and risk for injury. Instead, the nurse should provide the patient with activities to do while in bed, play music or video selections of the patient's choice, and reduce stimulation noise and light to calm the patient.
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