Urethral Urinary

Catheterization
 Urinary
Catheterization
 URINARY CATHETERIZATION

• The introduction of a catheter into the urinary bladder.

• It is usually performed only when absolutely necessary, because the danger
exist of introducing microorganisms into the bladder.
• Strict sterile techniques is used for catheterization.
 CATHETER
• Commonly made of rubber or plastic although they may be made from latex,
silicone, or polyvinyl chloride (PVC)
• They are sized by the diameter of the lumen using the French (Fr) scale: the larger
the number, the larger the lumen.
• There are three types of catheter known as:
- Straight Catheter,
- Coudé Catheter
- Foley/Retention Catheter.
TYPES OF CATHETER
1. Straight Catheter
• Single-lumen tube with a small eye or opening about 1 1/4 cm
(1/2 in.) from the insertion tip.

2. Coudé Catheter
• Is a variation of the straight catheter
• It is more rigid than other straight catheter and has a tapered,
curved tip.
• May be used for men with prostatic hypertrophy.
TYPES OF CATHETER
3. Foley/Retention Catheter
• It is a double-lumen catheter.
• Larger lumen drains urine from the bladder, a smaller lumen is used
to inflate a balloon near the tip of the catheter to hold the catheter
in place within the bladder.
• Sized by the volume of fluid used to inflate them.
• The two commonly used sized are 10mL and 30mL balloons.
 Performing Urethral
Urinary Catheterization
 Equipment:
• Sterile catheter of appropriate size (an extra catheter should also be at hand)

Catheterization kit :
• 1-2 pair sterile gloves • Forceps
• Waterproof drape(s) • Water-soluble lubricant
• Antiseptic solution • Urine receptacle
• Cleansing balls • Specimen container
 Equipment:
For an indwelling catheter:
• Syringe prefilled with sterile water in amount specified by catheter manufacturer
• 2% Xylocaine gel (if agency permits)
• Disposable clean gloves
• Supplies for performing perineal care
• Bath blanket or sheet for draping the client
• Adequate lighting (Obtain a flashlight or lamp if necessary)
Procedures:
• Note: Stand on the client’s right if you are right-handed or on the client’s left if you
are left-handed. Establish adequate lighting.
• Prior to performing the procedure, introduce self and verify the client’s identity using
agency protocol. Explain to the client what you are going to do, why it is necessary, and how
he/she can cooperate.
• Perform hand hygiene and observe appropriate infection control procedure.
• Provide client’s privacy
Procedures:
• Place the client in the appropriate position and drape all areas except the
perineum.
• Female – supine with knees flexed, feet about 2ft. apart, and hips slightly
externally rotated, if possible.
• Male – supine, thighs slightly abducted or apart.
• Establish adequate lighting.
 I. ORGANIZING SUPPLIES
1. If using a collecting bag and it is not contained within the catheterization kit,
open the drainage package and place the end of the tubing within reach.
2. Open the catheterization kit. Place a waterproof drape under the buttocks
(female) and penis (male) without contaminating the center drape with hands.
3. Put on sterile gloves.
4. Saturate the cleansing balls with the antiseptic solution.
 I. ORGANIZING SUPPLIES
5. Open the lubricant package.
6. Remove the specimen container and place it nearby with lid loosely on top.
7. Attach the prefilled syringe to the indwelling catheter inflation hub and test
the balloon.
8. Lubricate the catheter 1-2 inches for female and 6-7 inches for male and
place it with the drainage end inside the collection container.
 II. CLEANSING THE MEATUS
Note: the non-dominant is considered contaminated once it is touched the client’s skin.
Women:
 Use your non-dominant hand to spread the labia.
 Establish a firm but gentle position.
 Pick up a cleansing ball with the forceps in your dominant hand
 Wipe one side of the labia majora in an anteroposterior direction.
 II. CLEANSING THE MEATUS
Note: the non-dominant is considered contaminated once it is touched the client’s skin.
Women:.
 Use a new ball for the opposite side.
 Repeat for the labia minora.
 Use the last ball to cleanse directly over the meatus.
Note: location of the urethral meatus is best identifies during the cleansing process.
 II. CLEANSING THE MEATUS

Men:
Use your non-dominant hand to grasp the penis just below the glans.
Hold the penis firmly upright, with slight tension.
Pick up a cleansing ball with a forceps in your dominant hand
Wipe from the center of meatus in a circular motion around the glans
Use a new ball and repeat three more times
 III. INSERTING THE CATHETER
1 . Insert the catheter.
a. Grasp the catheter firmly 2 – 3 inches from the tip. Ask the
client to take a slow deep breath and insert the catheter as the
client exhales.
 III. INSERTING THE CATHETER
2. Hold the catheter with the non-dominant hand. In males, lay the penis down onto
the drape, being careful that the catheter does not pull out.
3. For indwelling catheter, inflate the retention balloon with the designated volume.
a. Without releasing catheter, hold the inflation valve between two fingers of your
non-dominant hand while you attach the syringe and inflate with your dominant
hand.
b. Pull gently on the catheter until resistance is felt to ensure that the balloon has
inflated and to place it in the trigone of the bladder.
 IV. TERMINATING THE CATHETER

1. Explain procedure to the patient.

2. Wash hand and don gloves.
3. Place a waterproof pad on the bed between the patient's legs.
4. Provide privacy and position the patient.
5. Attach the syringe to the inflation port on the catheter tubing, and pull
back on the syringe plunger until all the fluid is aspirated.
 IV. TERMINATING THE CATHETER

6. Slowly pull out the catheter tubing.

7. Dispose of the catheter and drainage bag.
8. Assist the patient with perineum care.
9. Wash hands.
10. Report and record.
11. Continue to monitor the patient for difficulties voiding after the catheter
has been removed.