# Place the key actions in order for inserting an indwelling urinary catheter using aseptic technique.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=568928&lang=en  
> language: en  
> subject: Emergency Response Plan  
> category: SIPC

## Question

Place the key actions in order for inserting an indwelling urinary catheter using aseptic technique.

Open the sterile kit, arrange the sterile field, and apply sterile gloves without contamination

Insert the catheter until urine flows, advance as directed, and inflate the balloon only after urine return confirms bladder placement

Connect or preserve the closed drainage system, secure the catheter, and keep the bag below bladder level and off the floor

Verify the indication and prescription, identify and explain to the client, provide privacy, perform hand hygiene, and position the client

Cleanse the urethral area with the supplied antiseptic using the required sterile sequence

## Explanation

Confirm that the catheter is indicated and prepare the client before creating the sterile field. Maintain sterility while opening the kit, gloving, and cleansing. Insert until urine return confirms bladder entry before balloon inflation. Preserve a closed system, secure the catheter, and position the drainage bag to prevent reflux and traction. Reassess daily whether the catheter remains necessary.

## In-depth explanation

Correct sequence
Verify and prepare → establish sterile field → cleanse → insert and confirm urine before balloon inflation → secure closed dependent drainage.

Why this is correct
CAUTI prevention begins with avoiding unnecessary catheterization and continues through aseptic insertion, a closed drainage system, unobstructed flow, and prompt removal.

NCLEX decision rule
If sterility is broken, replace the contaminated item. Never inflate the balloon without evidence that the catheter is in the bladder.References
1CDC: CAUTI recommendations
2CDC: CAUTI clinical safety

## Clinical scenario

CAUTI prevention at insertion
The catheter has an appropriate clinical indication. Follow the manufacturer's instructions and facility policy for insertion depth and balloon inflation.

## Key concepts

- **Closed Drainage System** — A sealed catheter and collection pathway that limits entry of microorganisms.
- **Dependent Drainage** — Gravity flow maintained by keeping the collection bag below bladder level without dependent loops or obstruction.
- **CAUTI** — A catheter-associated urinary tract infection related to an indwelling urinary catheter.

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