A female client with an indwelling urinary catheter is suspected of having a urinary tract infection. Nurse Angel should collect a urine specimen for culture and sensitivity by:
A. Disconnecting the tubing from the urinary catheter and letting the urine flow into a sterile container.
B. Wiping the self-sealing aspiration port with antiseptic solution and aspirating urine with a sterile needle.
C. Draining urine from the drainage bag into a sterile container.
D. Clamping the tubing for 60 minutes and inserting a sterile needle into the tubing above the clamp to aspirate urine.
Correct Answer: B. Wiping the self-sealing aspiration port with antiseptic solution and aspirating urine with a sterile needle.
Most catheters have a self-sealing port for obtaining a urine specimen. Antiseptic solution is used to reduce the risk of introducing microorganisms into the catheter. Thoroughly cleanse the Foley catheter at port, if available, or close to point of connection to drainage tubing with antimicrobial swabs.
Option A: Tubing shouldn’t be disconnected from the urinary catheter. Any break in the closed urine drainage system may allow the entry of microorganisms. The only way to get an uncontaminated sterile urine specimen from a urinary catheter is to remove the old catheter and insert a new catheter. This is the recommended method for obtaining a culture and sensitivity.
Option C: Urine in urine drainage bags may not be fresh and may contain bacteria, giving false test results. The urine should be withdrawn from a port on the tubing if available. If not available, the catheter may be punctured with syringe and needle only if the catheter is rubber and is self-sealing.
Option D: When there is no urine in the tubing, the catheter may be clamped for no more than 30 minutes to allow urine to collect. Clamp off drainage tubing distal to, or just below, the connection junction of the catheter and drainage bag tubing for 20-30 minutes. This will provide an accumulation of urine from which a specimen can be drawn.
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