The nurse is having difficulty inserting a urinary catheter in an older female client. Which position should the nurse place the client in to facilitate the insertion of the catheter?
1. Lithotomy with head of bed at 20 degrees
2. Side-lying, lifting up the buttock
3. Side-lying with both knees flexed
4. Supine with legs flexed and knees apart
2. Side-lying, lifting up the buttock
Explanation: 1. The older female client may have difficulty assuming a lithotomy position. The side-lying position results in greater comfort to the client.
2. Because of estrogen-mediated changes in the perineal area of postmenopausal women, the urinary meatus may be very difficult to visualize. Placing the client in a side-lying position and lifting up the buttock is an alternative that provides better visualization of the urinary meatus.
3. Placing the client side-lying with both knees flexed will not allow for visualization of the urinary meatus.
4. The supine position, regardless of the leg position or height of the bed, does not increase the visualization of the urinary meatus because it is more distal due to the changes in the perineal area.
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