A comatose client in the intensive care unit has an indwelling urinary catheter. Which action(s) should the nurse implement to reduce the incidence of catheter-associated urinary tract infections (UTIs)? Select all that apply. A)Cleanse periurethral area with antiseptics every shift B)Ensure each client has a separate container to empty collection bag C)Keep catheter bag below the level of the bladder D)Routinely irrigate the catheter with antimicrobial solution E)Use sterile technique when collecting a urine specimen

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Health care catheter-associated UTIs are prevalent among hospitalized clients with indwelling urinary catheters. Steps to prevent infections in clients with urinary catheters include the following: Wash hands thoroughly and regularlyPerform routine perineal hygiene with soap and water each shift and after bowel movementsKeep drainage system off the floor or contaminated surfacesKeep the catheter bag below the level of the bladderEnsure each client has a separate, clean container to empty collection bag and measure urineUse sterile technique when collecting a urine specimenFacilitate drainage of urine from tube to bag to prevent pooling of urine in the tube or backflow into the bladderAvoid prolonged kinking, clamping, or obstruction of the catheter tubingEncourage oral fluid intake in clients who are awake and if not contraindicatedSecure the catheter in accordance with hospital policy (tape or Velcro device)Inspect the catheter and tubing for integrity, secure connections, and possible kinks Wash hands thoroughly and regularly Perform routine perineal hygiene with soap and water each shift and after bowel movements Keep drainage system off the floor or contaminated surfaces Keep the catheter bag below the level of the bladder Ensure each client has a separate, clean container to empty collection bag and measure urine Use sterile technique when collecting a urine specimen Facilitate drainage of urine from tube to bag to prevent pooling of urine in the tube or backflow into the bladder Avoid prolonged kinking, clamping, or obstruction of the catheter tubing Encourage oral fluid intake in clients who are awake and if not contraindicated Secure the catheter in accordance with hospital policy (tape or Velcro device) Inspect the catheter and tubing for integrity, secure connections, and possible kinks (Option A) Perineal hygiene is performed using soap and water only every shift and as needed. Routine use of antiseptic cleansers is not shown to prevent infection and may lead to the development of drug-resistant bacteria. (Option D) Routine irrigation with antimicrobial solution or systemic administration of antimicrobials is not recommended for routine catheter care and infection prevention. Educational objective: Routine catheter care to prevent health care catheter-associated UTIs includes routine hand hygiene, cleansing the perineal area with soap and water routinely, keeping the catheter bag below the bladder and off the ground, keeping the catheter and tubing free of kinks and facilitating urine into the bag, and using sterile technique when collecting urine specimens.

A Comatose Client in the Intensive Care Unit Has an Indwelling