A nurse is discussing indications for urinary catheterization with a newly licensed nurse. Which of the following indications should the nurse include? Select all that apply.

Choice A rationale Routine catheterization solely for the convenience of staff or family is inappropriate, as it violates established infection prevention guidelines and client rights. Indwelling urinary catheters are a major source of healthcare-associated urinary tract infections (UTIs) because they introduce pathogens directly into the bladder, which outweighs any convenience factor. Catheters are only justified by specific medical necessity. Choice B rationale Obtaining a routine urine specimen for urinalysis or culture does not typically require the insertion of an indwelling or straight catheter, as a clean-catch midstream sample is usually sufficient and non-invasive. Catheterization is only indicated for specimens if the client cannot voluntarily void or if an uncontaminated sample is urgently needed and other methods have failed. Choice C rationale Strict intake and output (I O) monitoring is a valid indication for an indwelling catheter, especially in critically ill or unstable clients where hourly urine volume is crucial for assessing fluid balance, renal perfusion, and response to therapy. Accurate, continuous measurement is often impossible without a catheter in these complex situations. Choice D rationale Performing routine daily care, such as bathing or linen changes, is not a justifiable medical reason for inserting a urinary catheter. This non-therapeutic use unnecessarily exposes the client to the significant risks of catheter-associated urinary tract infection (CAUTI), mechanical trauma, and discomfort, and is strongly discouraged by best practice guidelines. Choice E rationale The presence of an unhealing open perineal or sacral wound, particularly one contaminated by urine or feces, is a valid indication for a temporary indwelling catheter. The catheter helps keep the area dry and free from continuous contamination, which is essential for wound healing and preventing further skin breakdown and infection. Choice F rationale Urinary retention, defined as the inability to empty the bladder, is a primary and necessary indication for catheterization (either straight or indwelling). The retention causes bladder distension and potentially serious complications like hydronephrosis or renal damage, requiring prompt catheter insertion for immediate therapeutic decompression and relief.