A patient with a urinary catheter develops fever and cloudy urine. What is the initial nursing action?

• A. Administer antibiotics immediately
• B. Assess catheter care; obtain urine culture if infection suspected; reinforce catheter hygiene and stability; consider removal if indicated
• C. Remove catheter immediately
• D. Do nothing

Answer: (B)

When a patient with an indwelling catheter develops fever and cloudy urine, think through a possible catheter-associated urinary tract infection. The best initial nursing action is to perform a focused assessment of the catheter and care practices: check that the system is closed and patent, ensure the drainage bag is below the bladder level and not kinked, verify the catheter is secured to prevent movement, and reinforce proper catheter hygiene. If infection is suspected, obtain a urine culture before starting antibiotics so the chosen therapy targets the specific organism and its sensitivities. At the same time, consider whether the catheter is still needed and evaluate the possibility of removal or replacement if indicated, since unnecessary or problematic catheters can perpetuate infection. This approach prioritizes confirming infection and optimizing catheter care over jumping to antibiotics or removal without assessment.