Urinary
Catheterization
Urinary Catheterization
• Is the insertion of urethral catheter into the urinary
bladder to drain urine or instill solution.
Types of Catheter
1
3
•Intermittent
•Indwelling Catheter
2
•Suprapubic Catheter
4
LOGO
Straight Catheter
Also called a red-rubber catheter or straight
catheter.
It is a single lumen and do not have a
balloon near the tip.
Straight catheter is inserted only for as
much time as it takes to drain the bladder
or obtain urine specimen.
Indwelling Catheter
• Also called foley or retention catheter.
• It has 2 lumen, one for the urine drainage and
the other for inflation of the balloon near the
tip. There are three-way foley catheters with a
third lumen for irrigation.
Intermittent
• The catheter is inserted and removed
immediately after emptying the bladder.
• To relieve acute urinary retention or when
medically indicated to obtain a urine
specimen, or to check post void residual
bladder volume
Straight Catheter
Coude Catheter
2 Way Foley Catheter
3 Way Foley Catheter
Condom Catheter
Catheter length
• Catheters are available in 3 lengths: Pediatric, Regular
length and Female length.
• Female length is a shorter length catheter (20-25cm). A
shorter length catheter may be more convenient for
ambulant women with a long term catheter.
• A shorter length catheter is not appropriate for all
women particularly those who are bedridden or obese.
• In obese women, the inflation valve of the shorter
catheter may cause soreness by rubbing against the
inside of the thighs, and the catheter is more likely to
pull on the bladder neck
BALLOON SIZE
• Balloon sizes: 5 – 30 mls. The most commonly
indicated balloon size is 10ml.
• Always inflate the balloon to the manufacturers
recommended volume indicated on the inflation
valve of the catheter as well as written on the
packaging. The balloon should be fully inflated to
the recommended size.
• Under-inflated balloons may occlude the
drainage holes of the catheter, or cause
distortion of the catheter tip, leading to irritation
and trauma to the bladder wall
Purposes
 To relieve acute or chronic urinary retention / bladder distention.
 To promote urinary drainage prior to diagnostic procedure or
surgery.
 To empty the urine from the bladder, prostate or vaginal surgery.
 To determine amount of residual urine output in critically ill
patient.
 To collect urine specimen from a client with bladder incontinence
or from a female with menstruation.
 To instill a medications into the bladder.
 To keep perineal area dry to assist healing
 Determine accurate fluid balance
 To collect a sterile specimen of urine.
Special Considerations
 Check the doctor’s order.
 Provide privacy. Invasive procedure elicit anxiety and
feeling of embarrassment.
 Use a calm, straight forward, professional manner to
relieve the patient’s anxiety.
 Practice aseptic technique. Urinary bladder is a
sterile cavity.
 Provide perineal care before catheterization.
 Facilitate insertion of the catheter, prevent pain
Equipment
 Tray with towel lining containing the following:
 Catheterization Set: Sterile drape or towel
Sterile kidney basin
Sterile medicine glass
Sterile specimen bottle
 Urinary catheter:
Single lumen straight catheter
Double lumen indwelling catheter
Triple lumen indwelling catheter
Sizes
• Fr. 8
- infants and children
• Fr. 14 – 16 - females
• Fr. 16 – 20 - males
Urinary Catheterization
 Sterile gloves
 Droplight
 Sterile cotton swabs
 Povidone iodine
solution
 Sterile pick-up forceps
 Water soluble lubricant
 Sterile 4x4 gauze
 Clean emesis basin
• Additional equipment for
indwelling catheters
• Drainage tubing and
collecting bag
• Sterile syringe and needle
with 5 ml or 30 ml
• Adhesive tape
• Bed pan
Urinary Drainage Bag
CATHETER DRAINAGE BAG SELECTION
1. Disposable 2 litre plastic bags (night bag)
• For general use.
• Catheter bags should have 120cm length
tubing with an outlet port to allow emptying.
• It is recommended that catheter bags also
have one-way valves to prevent urine backflow,
and an access port for the collection of urine
specimens.
• Bags should be changed when they become
damaged, contaminated, malodorous and at
catheter changes
CATHETER DRAINAGE BAG
SELECTION
2. Disposable Leg Bags (500-750mls)
• Designed for day wear and can be secured to the leg in a
variety of ways eg straps, legi fix catheter bag holders
strapped from the waist. (Leg bags can also be used to reduce
trauma for the confused or forgetful patient while in hospital)
• Tubing on leg bags is available in different lengths and
can be tailored to individuals requirements. Some people may
choose to wear the leg bag on their thigh, others prefer to
wear the leg bag on their calf. Again others may prefer “the
bellybag”
• The general recommendation for changing disposable
drainage bags is weekly or when they become damaged,
odorous or have sediment in the bottom.
CATHETER DRAINAGE BAG
SELECTION
3. Disposable 4 liter plastic bags
• • Bags with non returnable valve. Used post
operatively in urology and for bladder
• irrigation.
• • Usually short term and only changed if
damaged, contaminated or malodorous.
Male Catheterization
1. Assess the patient’s need for catheterization and
refer patient to the doctor.
2. Verify the doctor’s order for catheterization.
3. Prepare for the necessary materials.
4. Perform handwashing.
5. Identify the right patient.
• Explain the procedure.
• Position the patient properly, supine position.
Ensure privacy.
• Practice aseptic technique in the entire
procedure.
• Open the catheterization kit.
• Add and prepare the materials to be used.
Male Catheterization
11.Don first glove and fill the syringe with sterile water.
12.Don second glove and applies sterile drapes for the
patient.
13.Grab the penis firmly behind the glans with the nondominant hand and retracts the foreskin of the
uncircumcised male.
• With the dominant hand, use sterile forcep to
pick up swabs. Clean first from the meatus and
then wipe the tissue surrounding the meatus in
circular motion using a new swab for each stroke.
• Pick up the catheter and place the drainage end
of the catheter in the urine receptacle using the
uncontaminated hand.
• Lubricate the insertion end or tip of the catheter.
Male Catheterization
17.Lift the penis to a position of 90 degree angle and insert the
catheter until urine flows.
18.Connect the catheter to the urine bag and ensure that the
emptying base of the bag is closed.
19.Inflate the balloon by injecting 5 – 10 cc of PNSS and check for
anchorage.
20.Tape the catheter into the thigh using non-allergenic tape.
21.Dispose soiled materials properly.
22.Accurately record the procedures done.
Female Catheterization
1. Assess the patient’s need for catheterization and
refer patient to the doctor.
2. Verify the doctor’s order for catheterization.
3. Prepare for the necessary materials.
4. Perform handwashing.
5. Identify the right patient.
• Explain the procedure.
• Position the patient properly, supine position.
Ensure privacy.
• Practice aseptic technique in the entire
procedure.
• Open the catheterization kit.
• Add and prepare the materials to be used.
Female Catheterization
11.Don first glove and fill the syringe with sterile water.
12.Don second glove and applies sterile drapes for the patient.
13.With the non-dominant hand, separate the labia minora with thumb and
index finger. Never remove fingers until catheter is inserted.
14.With the dominant hand, use sterile forcep to pick up swabs. Clean first
from the meatus and then wipe the tissue surrounding the meatus in
circular motion using a new swab for each stroke.
15.Pick up the catheter and place the drainage end of the catheter in the
urine receptacle using the uncontaminated hand.
16.Lubricate the insertion end or tip of the catheter.
Female Catheterization
17.Lift the penis to a position of 90 degree angle and insert the
catheter until urine flows.
18.Connect the catheter to the urine bag and ensure that the
emptying base of the bag is closed.
19.Inflate the balloon by injecting 5 – 10 cc of PNSS and check for
anchorage.
20.Tape the catheter into the thigh using non-allergenic tape.
21.Dispose soiled materials properly.
22.Accurately record the procedures done.
Female Catheterization
Female Catheterization