رجل عمره ٧٨ سنة منوم منذ ٦ أيام بعد كسر ورك، وعنده قسطرة بولية من يوم العملية. اليوم حرارته ٣٨٫٤، ومشوش قليلاً، والبول عكر، والنبض ١٠٤. الطبيب يسأل عن خطة القسطرة. ما الإجراء التمريضي الأهم؟

A 78-year-old man admitted 6 days ago with a hip fracture has had a urinary catheter since surgery. Today T 38.4 °C, mild confusion, cloudy urine, HR 104. The doctor asks about the catheter plan. What is the most important nursing action?

1. Assess the need for the catheter, remove it early and send a culture
2. Change only the drainage bag and keep the catheter for another week
3. Irrigate the bladder daily with saline to wash out bacteria
4. Hang the bag above bladder level to speed drainage

Answer: A) Assess the need for the catheter, remove it early and send a culture. CAUTI risk rises with catheter duration. Removal as soon as possible is the key prevention and treatment, with culture and antibiotics as ordered and the bag kept below the bladder.