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Difficulty: MediumReduction of Risk Potential

A practical nurse (PN) is preparing to collect a sterile urine specimen for culture and sensitivity from a client who has a closed indwelling urinary catheter system. After performing hand hygiene and donning clean gloves, in what order should the PN perform the following actions to reduce the risk of infection and ensure an accurate laboratory sample? (Arrange the steps in the correct sequence from first to last.)

  1. 1Clamp the drainage tubing just below the sampling port for 15 to 30 minutes.
  2. 2Scrub the needleless sampling port vigorously with an antimicrobial swab.
  3. 3Attach a sterile syringe to the sampling port and withdraw the required volume of urine.
  4. 4Transfer the collected urine from the syringe into a sterile specimen container.
  5. 5Unclamp the catheter drainage tubing to restore continuous gravity flow.

Answer

The correct sequence is: Clamp the tubing below the port, scrub the sampling port, withdraw urine with a sterile syringe, transfer the urine to a sterile container, and finally unclamp the drainage tubing.
The correct sequence ensures that a fresh, uncontaminated sample is collected directly from the closed urinary system while minimizing the risk of introducing pathogens. Clamping allows fresh urine to gather, proper disinfection prevents CAUTI, aseptic withdrawal and transfer maintain sample integrity, and unclamping is essential to prevent severe physical complications from urinary retention.

Step-by-Step Solution

1
Clamp the drainage tubing just below the sampling port for 15 to 30 minutes.
Freshly produced urine collects in the tubing.
Urine in the main drainage bag is stagnant and not suitable for accurate culture due to potential bacterial overgrowth at room temperature.
2
Scrub the needleless sampling port vigorously with an antimicrobial swab.
The access site is disinfected.
Disinfecting the port prevents the introduction of outside microorganisms into the sterile closed urinary system.
3
Attach a sterile syringe to the sampling port and withdraw the required volume of urine.
A sterile sample is securely obtained.
Using a sterile syringe ensures the sample remains uncontaminated during withdrawal.
4
Transfer the collected urine from the syringe into a sterile specimen container.
The sample is safely prepared for laboratory transport.
The laboratory requires a sterile container to ensure that any bacterial growth in the culture originates from the client's urinary tract, not the environment.
5
Unclamp the catheter drainage tubing to restore continuous gravity flow.
Normal urinary drainage resumes.
Prevents dangerous complications such as bladder distention, retrograde infection, and autonomic dysreflexia.

Key Concept

Reduction of Risk Potential: Infection Control and Complication Prevention
Estimated Time:1m 15s
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Topics

Reduction of Risk Potential

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