The nurse is preparing a bladder irrigation for an adult client who has a long-term indwelling urinary catheter. The urine is cloudy with fibrin clots and sediment. Which intervention should the nurse implement?

Power flush with 60 mL to remove mucous obstructions.

Slowly irrigate catheter with saline using an infusion pump.

Clamp the catheter for 30 minutes prior to irrigating.

Use a sterile syringe to irrigate with 20 mL normal saline.

Answer and Explanation

The Correct Answer is B

A. Power flushing with 60 mL might be too forceful and could potentially damage the bladder or catheter. It is important to use a gentle approach to avoid complications.
B. Slowly irrigating the catheter with saline using an infusion pump is appropriate for gently clearing the clots and sediment while maintaining a controlled flow rate. This method is effective in managing obstructions and maintaining catheter patency.
C. Clamping the catheter before irrigation is not recommended as it could lead to increased bladder pressure and discomfort. The goal is to maintain urine flow and prevent complications from clots.
D. Using a sterile syringe to irrigate with 20 mL normal saline may not be sufficient to clear larger clots and sediment. A controlled, slower irrigation method using an infusion pump is generally preferred.

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Correct Answer is D

Explanation

A. Asking vague or nonspecific questions can lead to unclear answers, which may hinder the assessment process. Specific and direct questions are more effective.
B. Starting with the most difficult questions may make the client uncomfortable and less willing to share information. It's better to build rapport first.
C. Sharing personal values is not appropriate as it may influence or pressure the client. The focus should be on the client’s values and experiences.
D. Beginning with questions that are less sensitive helps to build rapport and trust with the client, making them more comfortable discussing more sensitive topics later in the conversation.

A. Dizziness can occur during cleansing. B. Foreskin should not be retracted. C. An erection may occur while providing care. D. Pubic area should be kept shaved.

Correct Answer is B

Explanation

A. Dizziness during perineal cleansing is not a common concern and should not be included as a standard part of perineal care instructions.
B. For male clients, the foreskin should be retracted gently if it is retractable to clean the area underneath. However, if the foreskin is not retractable or if retraction causes discomfort, it should not be forced. This instruction is crucial for proper hygiene and prevention of infection.
C. While an erection can occur, it is not a standard concern to highlight during perineal care education. The focus should be on proper technique and hygiene.
D. Shaving the pubic area is not necessary for perineal care and can potentially cause irritation or increase the risk of infection. Proper hygiene practices are more important than hair removal.

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The nurse is preparing a bladder irrigation for an adult client who has a long-term indwelling urinary catheter. The urine is cloudy with fibrin clots and sediment. Which intervention should the nurse implement?

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Naxlex Comprehensive Predictor Exams

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