MABULAY, JARED M

2Nur6
RLE 2
PAGDILAO
Assessment
Subjective:
No
subjective
cues.
Objective:
Temp: 36.7
C
HR: 89 bpm
RR: 22 bpm
BP: 160/100
mmHg

MAAM
Nursing Diagnosis
Risk for urinary
tract infection r/t
the presence of an
indwelling catheter

Objectives
The client will remain
free of urinary tract
infection AEB:
1. Clear urine
2. Absence of
dysuria
3. Absence of
hyperthermia
4. Normal urinalysis
results

Nursing Intervention
Independent:
1. Maintain a fluid intake of
at least 2500 ml/day
unless contraindicated
2. Assist client with
perineal care routinely

3. Maintain sterile
technique during
catheterization and
irrigations.
4. Secure the catheter
tubing to thigh on
females.

5. Keep urine collection

container below bladder
level at all times.
Dependent:
6. If signs and symptoms
of urinary tract infection
occur, administer
antimicrobials if ordered.

Rationale
1. Promotes urination
which flushes out
pathogens from urethra
or bladder.
2. To lessen the possibility
of bacteria growing near
the sensitive area.
3. To minimize the chance
of microbial
contamination of the
catheter which might
cause infection.
4. To minimize risk of
accidental traction on
the catheter and cause
subsequent trauma to
the bladder and urethra.
5. To prevent reflux or
stasis of urine.

6. To kill any possible

growth that may worsen
if untreated,

Evaluation
Short term:
The client shall
not develop a
urinary tract
infection whilst
staying in the
hospital.
Long term:
The client shall
not develop a
urinary tract
infection whilst
staying in the
hospital and
after being
discharged due
to the use of an
indwelling
catheter. .