No urine output for 1 to 2 hours, sudden cessation, or bladder distension signals obstruction; assess and report.
Before you read
Test yourself first: 3 questions
Question 1 of 3
A nurse is preparing to care for four clients. Which client is at the highest risk for developing a health-care-associated infection?
Answer: A. An indwelling urinary catheter provides a direct portal of entry and is a leading cause of health-care-associated infections, especially in an older adult with reduced defenses.
Question 2 of 3
Which nursing action best prevents catheter-associated urinary tract infections (CAUTI)?
Answer: C. Maintaining a closed urinary drainage system and keeping the collection bag below the level of the bladder prevents reflux of urine and reduces CAUTI risk. Early removal of unnecessary catheters is also key.
Question 3 of 3
To prevent caregiver back injury when moving a client, the nurse should:
Answer: B. Use proper body mechanics and mechanical lifts/assist devices, get help, keep the load close, bend the knees, and avoid twisting. Lifting heavy clients alone risks injury.
Keep the streak going with more questions like these, each with a full rationale.
What is indwelling urinary catheter care?
It is the leading cause of catheter-associated urinary tract infection (CAUTI), so the priority is strict sterile insertion, closed drainage, and removing it as soon as it is no longer needed. Key principle: keep the system closed and the bag below the bladder.
Key points to remember
- Insertion is a sterile procedure; perineal/meatal cleansing during routine care uses soap and water, not antiseptics.
- Keep the drainage bag below the level of the bladder at all times to prevent backflow, but off the floor.
- Maintain an unobstructed, dependent, closed drainage system with no kinks or dependent loops.
- Anchor (secure) the catheter to the thigh or abdomen to prevent traction on the urethra.
- Empty the bag when half to two-thirds full and before transport; use a separate clean container per client.
- Early removal is the single most effective way to reduce CAUTI risk.
Nursing priorities
- Perform perineal care and clean the catheter from meatus outward at least daily and after bowel movements.
- Keep the bag below bladder level and the tubing free of kinks and dependent loops.
- Maintain a closed system; obtain specimens from the sampling port using aseptic technique, not by disconnecting tubing.
- Encourage fluids (2 to 3 L/day unless contraindicated) to flush the system.
- Assess daily for continued need and advocate for prompt removal.
Labs & values
Patient teaching
- Keep the bag below the bladder when sitting, standing, and walking.
- Drink plenty of fluids and report burning, fever, cloudy urine, or no urine draining.
- Wash hands before and after handling the catheter or bag.
Red flags: report now
- No urine output for 1 to 2 hours, sudden cessation, or bladder distension signals obstruction; assess and report.
- Cloudy, foul-smelling urine, fever, suprapubic or flank pain, or new confusion suggests CAUTI; report.
- Never raise the drainage bag above the bladder or disconnect the closed system unnecessarily.
References
Clinical references for this topic
