A client is hospitalized with urinary retention, has an indwelling catheter, and is getting IV fluids. Which intervention does the nurse add to the care plan to address the priority problem for this client?
a. Perform catheter care per policy every shift.
b. Encourage fluid intake to 1 liter/day.
c. Apply a moisture barrier cream daily.
d. Document accurate intake and output (I&O) each shift.
A
The most common cause of sepsis in hospitalized clients is a urinary tract infection. Ascending infection from cystitis with an indwelling catheter is a major source of such infections. Encour-aging fluids and documenting I&O are probably important interventions, but they do not take priority over preventing a catheter-related infection. Moisture barrier cream would not be needed.
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