When urethral injury is suspected, what are nursing priorities during catheterization?

• A. Avoid forceful insertion, use lubrication, gentle advancement; consider suprapubic catheter; notify physician and secure alternative plan
• B. Forceful insertion to overcome resistance
• C. Delay catheterization indefinitely
• D. Use unlubricated catheter

Answer: (A)

The main concept is protecting the urethra and ensuring safe urinary drainage when a urethral injury is possible. Do not force a catheter; resistance can indicate tissue damage or a false passage, and forcing can worsen injury or cause a rupture. Use lubrication and advance only as tolerated, stopping at any sign of resistance or pain. If drainage is still necessary, consider a suprapubic catheter as an alternative route, and involve the physician to determine the safest approach. Document the plan and notify the physician promptly to secure an appropriate management plan, which may include external drainage or imaging as indicated.