What is the main nursing priority when a patient has a newly placed urethral catheter postoperatively?

• A. Maintain a closed drainage system, ensure catheter is secured, prevent kinking, and monitor for bladder distention.
• B. Remove the catheter immediately after surgery
• C. Irrigate the catheter hourly
• D. Increase IV fluids to flush catheter

Answer: (A)

The main concept is preventing postoperative urinary drainage problems by keeping the catheter system closed and functioning smoothly. The top priority is to maintain a closed drainage system, secure the catheter so it won’t kink or be pulled out, and ensure the urine can flow freely into the collection bag. When the catheter is secure and the system remains patent, urine drains continuously, reducing the risk of bladder distention and infection while you can accurately monitor output.

Keeping the system closed helps prevent bacteria from entering the bladder, and securing the catheter prevents accidental dislodgement or tugging that could disrupt healing. Watching for signs of bladder distention is essential because it can signal a blockage or kinking somewhere in the catheter or tubing, which requires prompt assessment and correction to restore drainage.

Removing the catheter immediately would defeat its purpose for postoperative drainage and monitoring. Irrigating the catheter hourly is not routinely needed and can introduce infection risk unless specifically ordered. Simply increasing IV fluids to flush the catheter does not address drainage or patency and may not be appropriate.