A nurse is preparing to insert an indwelling urinary catheter for a client. Which of the following actions should the nurse plan to take?
A) Test the balloon on the indwelling urinary catheter before insertion.
B) Use one cotton swab to clean the client’s urinary meatus.
C) Don sterile gloves before inserting the indwelling urinary catheter.
D) Apply an oil-based lubricant to the indwelling urinary catheter.
The Correct Answer and Explanation is:
Correct Answer: C) Don sterile gloves before inserting the indwelling urinary catheter.
Explanation:
When performing urinary catheterization, the priority is to maintain a sterile field to prevent the introduction of pathogens into the urinary tract, which could result in a catheter-associated urinary tract infection (CAUTI). Therefore, donning sterile gloves before inserting the catheter is an essential step.
Option C is correct because the insertion of an indwelling urinary catheter is a sterile procedure. After preparing the sterile field and cleansing the perineal area (usually with antiseptic solution such as povidone-iodine), the nurse must apply sterile gloves to handle the catheter and maintain asepsis throughout the process. Sterile gloves protect both the patient and the equipment from contamination. A break in sterility can introduce bacteria into the bladder, leading to infection.
Let’s consider the incorrect options:
- Option A: Test the balloon on the indwelling urinary catheter before insertion.
This is an outdated practice. Manufacturers now test the balloon before packaging. Pre-testing can cause defects or compromise the balloon’s integrity, increasing the risk of trauma during insertion or failure of balloon inflation after placement. - Option B: Use one cotton swab to clean the client’s urinary meatus.
This is incorrect because proper technique requires using multiple antiseptic swabs or cotton balls—typically one for each outward stroke (labia majora, labia minora, then the meatus in females; in males, circular motion from the meatus outward). This reduces the risk of introducing bacteria into the urinary tract. - Option D: Apply an oil-based lubricant to the indwelling urinary catheter.
This is incorrect because oil-based lubricants can interfere with latex catheters and may not be sterile. A water-soluble lubricant should always be used to reduce friction and trauma during insertion.
Summary:
Sterile technique, including donning sterile gloves, is vital when inserting an indwelling urinary catheter to reduce the risk of infection. Therefore, the correct answer is C.