medium · NCLEX-RN safety
A 74-year-old female with a long-term indwelling urinary catheter is asymptomatic. A routine urine culture obtained during a scheduled catheter exchange grows >100,000 CFU/mL of carbapenem-resistant Enterobacterales (CRE) sensitive to tigecycline and polymyxin B. She has no fever (temperature 36.9 C [98.4 F]), normal white blood cell count (7.0 x 10^3/uL), and no abdominal or suprapubic pain.
The provider orders IV polymyxin B. Which action should the nurse take?
- Hold the polymyxin B and contact the provider to discuss holding antibiotic therapy, as treating asymptomatic catheter-associated colonization violates antimicrobial stewardship.
- Irrigate the indwelling catheter with sterile normal saline to flush out the CRE colonies.
- Obtain an immediate repeat urine specimen from the catheter port to verify the culture result before administering the drug, at this point in care, based on the current findings.
- Administer the polymyxin B as ordered to eradicate the highly resistant CRE from the urinary tract, based on the current findings, based on the information currently available.
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