A 40-year-old paraplegic must perform intermittent catheterization of the bladder. Which of the following instructions should be given?
A. “Clean the meatus from back to front.”
B. “Measure the quantity of urine.”
C. “Gently rotate the catheter during removal.”
D. “Clean the meatus with soap and water.”
Correct Answer: D. “Clean the meatus with soap and water.”
Intermittent catheterization may be performed chronically with a clean technique, using soap and water to clean the urinary meatus. Cleanse the perineal area and keep dry. Provide catheter care as appropriate. Decreases risk of skin irritation or breakdown and development of ascending infection.
Option A: The meatus is always cleaned from front to back in a woman, or in expanding circles working outward from the meatus in a man. Observe for cloudy or bloody urine, foul odor. Dipstick urine as indicated. Signs of urinary tract or kidney infection that can potentiate sepsis. Multistrip dipsticks can provide a quick determination of pH, nitrite, and leukocyte esterase suggesting the presence of infection.
Option B: It isn’t necessary to measure the urine. The nurse may measure residual urine via post void catheterization or ultrasound. Helpful in detecting the presence of urinary retention and effectiveness of the bladder training program. Note: Use of ultrasound is noninvasive, reducing the risk of colonization of the bladder.
Option C: The catheter doesn’t need to be rotated during removal. Keep the bladder deflated by means of an indwelling catheter initially. Begin intermittent catheterization program when appropriate. Intermittent catheterization may be implemented to reduce complications usually associated with long-term use of indwelling catheters.
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