NORCET 7 Prelims -2024
Medical & Surgical Nursing (E5)
Easy
A nurse is setting up a three-way urinary catheter for a patient. What is the purpose of this catheter?
Appeared in: NORCET 7 Prelims -2024
Explanation
- A three-way catheter, also known as a triple-lumen catheter, is specifically designed for Continuous Bladder Irrigation (CBI).
- The third lumen's dedicated function is to instill a sterile solution into the bladder.
- This irrigation is crucial after genitourinary surgeries (like TURP) to continuously flush the bladder, preventing the formation of blood clots that can obstruct urine outflow.
- By keeping the bladder clear of clots and sediment, the catheter maintains patency and allows for proper drainage.
Why Other Options Were Wrong
- Option A: While the catheter does drain blood, this is a function of any drainage catheter. The unique purpose of the third lumen in a three-way catheter is active irrigation to PREVENT clots, which is a more specific and primary function than just passive drainage.
- Option C: Monitoring urine output is a standard function of urinary catheters, but it can be accomplished with a simpler, two-lumen (Foley) catheter. Using a three-way catheter solely for this purpose is unnecessary and not its primary indication.
- Option D: IV (intravenous) fluids are formulated for administration into the bloodstream. Instilling them into the bladder is incorrect and serves no therapeutic purpose. The bladder is irrigated with specific sterile irrigating solutions, such as normal saline.
Related Visual
- Visual 1: Diagram: A labeled illustration of a three-way (triple-lumen) catheter, clearly showing the path for balloon inflation, urine drainage, and irrigation instillation.
- Visual 2: Flowchart: A simple flowchart depicting the setup for Continuous Bladder Irrigation (CBI), showing the irrigation bag, tubing, three-way catheter, and drainage bag.
- Visual 3: Infographic: A visual guide comparing a two-lumen Foley catheter with a three-lumen irrigation catheter, highlighting their different components and uses.
Clinical Relevance
- Nursing practice connection: Use the key finding related to Purpose and function of a three-way urinary catheter and Continuous Bladder Irrigation (CBI) to guide bedside assessment, documentation, and the next nursing action.
- Patient safety is paramount during CBI. The nurse must meticulously track intake and output to prevent bladder distention, which can lead to pain, bladder rupture, and hemorrhage.
- A sudden decrease or cessation of urine output is a medical emergency. The nurse's first action is to check for tubing kinks or clots. If not resolved, the provider must be notified immediately as manual irrigation or catheter replacement may be needed.
- What if? If the patient complains of severe bladder spasms and the urge to void while on CBI, the nurse should first check for catheter obstruction. Spasms are often caused by the bladder trying to expel a clot or the catheter balloon.
How to Approach the Question
- First, identify the key term in the question: 'three-way urinary catheter'.
- Recall the unique feature of this device compared to a standard (two-way) catheter. The name 'three-way' implies three channels or lumens.
- Think about the function of each lumen: one for the balloon, one for drainage, and a third, extra one. Ask yourself, 'What is this extra channel for?'
- Evaluate the options based on this unique feature. The third lumen allows for putting fluid in while fluid is also coming out.
- Option B, 'irrigate the bladder and prevent clot formation,' directly describes a process of instilling fluid to wash out the bladder, which perfectly matches the capability of a three-way system.
- Eliminate other options: simple drainage (A) and monitoring output (C) don't require a third lumen, and administering IV fluids into the bladder (D) is anatomically and physiologically incorrect.
Concept Tested & Keywords
- Concept Tested: Purpose and function of a three-way urinary catheter and Continuous Bladder Irrigation (CBI).
- Stem keywords: three-way urinary catheter, purpose
- Lead-in keywords: What is the purpose
Question ID
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Practise the full NORCET 7 Prelims -2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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