Which of the following procedures always requires surgical asepsis?
A. Vaginal instillation of conjugated estrogen
B. Urinary catheterization
C. Nasogastric tube insertion
D. Colostomy irrigation
Correct Answer: B. Urinary catheterization
The urinary system is normally free of microorganisms except at the urinary meatus. Any procedure that involves entering this system must use surgically aseptic measures to maintain a bacteria-free state. Guidelines from The Centers for Disease Control and Prevention (CDC) and The European Association of Urology Nurses (EAUN) recommend ‘sterile technique’ when inserting an indwelling urinary catheter. Insertion of indwelling urinary catheters should be performed in a way that minimizes the risk of introducing bacteria to the urinary bladder.
Option A: Conjugated estrogens is a medicine that contains a mixture of estrogen hormones. Conjugated estrogen vaginal cream is used to treat changes in and around the vagina (such as vaginal dryness, itching, and burning) caused by low estrogen levels or menopause. It is also used to treat vaginal pain during sexual intercourse. This medicine is to be used only in the vagina. Use at bedtime unless your doctor tells otherwise.
Option C: Nasogastric (NG) intubation is a procedure in which a thin, plastic tube is inserted into the nostril, toward the esophagus, and down into the stomach. Once an NG tube is properly placed and secured, healthcare providers such as the nurses can deliver food and medicine directly to the stomach or obtain substances from it. Clean, not sterile, technique is necessary because the gastrointestinal (GI) tract is not sterile.
Option D: Sterile supplies are used in acute care with a fresh post-surgical urostomy. A patient in the community may not use sterile supplies, but strict adherence to proper hand hygiene is required to prevent infections of the bladder, kidney, or urinary tract. Never place anything inside the stoma.