A client has a ureteral catheter in place after renal surgery. A priority nursing action for care of the ureteral catheter would be to:
A. Irrigate the catheter with 30 ml of normal saline every 8 hours.
B. Ensure that the catheter is draining freely.
C. Clamp the catheter every 2 hours for 30 minutes.
D. Ensure that the catheter drains at least 30 ml an hour.
Correct Answer: B. Ensure that the catheter is draining freely.
The ureteral catheter should drain freely without bleeding at the site. Ensure nephrostomy is secure at all times with drain fixation dressing (and secondary film dressing if required). Check drainage tubing is patent and not kinked/twisted. At night, the patient and/or carer should be taught to attach a larger-volume night drainage bag to ensure a comfortable night’s sleep.
Option A: The catheter is rarely irrigated, and any irrigation would be done by the physician. Drainage bags should be changed every 5-7 days, while good hand hygiene is vital when handling the drain and exit site and emptying the drainage bag.
Option C: The catheter is never clamped. Nephrostomy tubes should be routinely changed every three months as recommended by the manufacturer. The nephrostomy bag should be emptied when it becomes three-quarters full and, where appropriate, the patient or carer should be taught how to do this.
Option D: The client’s total urine output (ureteral catheter plus voiding or Foley catheter output) should be 30 ml/hour. Ensure fluid-balance chart is in progress, with urine measurements taken once or twice an hour; if urine output is <30ml/hour, inform the member of the medical team.
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