An elderly patient admitted into the ER one week ago has had an indwelling urinary catheter since then. The nurse assesses the patient on morning rounds and finds the patient is disoriented, which is not the baseline for the patient. The nurse notes the urine in the drainage bag is dark and concentrated with sediment. The nurse should do which of the following?


•The nurse should report these findings and the length of time the catheter has been in place to the physician. Ideally, an order will be obtained to discontinue the catheter. Evaluation and treatment for the resulting infection will be necessary.

•An indwelling urinary catheter is the number one cause of healthcare-associated infections.

•The need for an indwelling catheter should be reevaluated daily during a hospital stay. The longer a urinary catheter is in place, the higher the risk for infection.

•The elderly are at even higher risk for urinary catheter-related infections and adverse reactions to these infections. Some possible adverse events resulting from indwelling urinary catheter infections include: disorientation, nephritis, bacteremia, sepsis, and death.

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