Urinary Catheterization
By: Miguel Badaguas
Urinary Catheterization is
the introduction of a
catheter
through
the
urethra into the bladder for
the
purpose
of
withdrawing urine.
Two MAIN Types of Urinary Catheter:
•Intermittent catheters – catheters that
are temporarily inserted into the
bladder and removed once the bladder
is empty.
•Indwelling catheters – catheters that
remain in place for many days or
weeks and are held in position by a
water-filled balloon in the bladder.
Purpose:
•To relieve urinary retention
•To obtain a sterile urine specimen
from a woman
•To measure the amount of residual
urine in the bladder
•To obtain a urine specimen when a
specimen
cannot
secure
satisfactory by other means
•To empty bladder before and
during surgery and before certain
diagnostic examinations
Equipments:
•
•
•
•
•
•
•
•
•
Sterile catheter
Sterile gloves
Waterproof drape(s)
Antiseptic solution
Cleansing balls
Forceps
Water-soluble lubricants
Urine receptacle
Specimen container
• For an indwelling catheter
• Syringe prefilled with sterile water in an amount specified by
catheter manufacturer.
• Collection bag and tubing
• Clean gloves
• Supplies for performing perineal care
• Bath blanket or sheet for draping
• Adequate lighting.
Sizes of Catheter
•Catheters are graded on the French scale according to the size of
the lumen.
•For the female adult, No. 14 and No. 16 French catheters are usually
used. Small catheters are generally not necessary and the size of the
lumen is also so small that it increases the length of time necessary for
emptying the bladder.
•Larger catheter distends the urethra and tends to increase the
discomfort of the procedure.
•For male adult, No.18 and No. 20 French catheters usually used, but
if this appears to be too large, smaller catheter should be used.
•No. 8 and No. 10 French catheters are commonly used for children.
Preparation of the patient:
1.Adequate exploration. On some instances, catheterization is the
last resort, use other techniques first for drawing out the urine before
proceeding to catheterization.
2.Position. Dorsal recumbent for the female and supine for the male
using a firm mattress or treatment table, Sim’s or lateral position can
be an alternate for the female patient
3.Provision for privacy
Procedure:
1.Inflate the balloon with the prefilled syringe before inserting the catheter
to check for balloon patency. Aspirate the fluid back into the syringe when
it is determined that the balloon is patent.
2.Hold the catheter with one hand and inflate the balloon according to the
manufacturer’s instructions, as soon as the catheter is in the bladder and
urine has begun to drain from the bladder. Usually 5 ml to 10 ml of sterile
water is used
3.If the patient complains of pain after the balloon is inflated, allow it to
empty and replace the catheter with another one. The balloon is probably
located in the urethra and is causing discomfort owing to distention of the
urethra
Procedure:
4. Exert slight tension on the catheter after the balloon is inflated to
assure its proper placement in the bladder
5. Connect the catheter to the drainage tubing and drainage bag if not
already connected
6. Tape the catheter along the anterior aspect of the thigh for a female
patient. Be sure there is no tension on the catheter when it is taped to
the patient
7. Hang the drainage bag on the frame of the bed below the level of the
bladder
Caring for patient with indwelling catheter
1.Be sure to wash hands before and after caring for a patient with an
indwelling catheter
2.Clean the perineal area thoroughly, especially around the meatus, twice
a day and after each bowel movement. This helps prevent organisms for
entering the bladder
3.Use soap or detergent and water to clean the perineal area and rinse
the area well
4.Make sure that the patient maintains a generous fluid intake. This helps
prevent infection and irrigates the catheter naturally by increasing urinary
output
5.Encourage the patient to be up and about as ordered
Caring for patient with indwelling catheter
6. Record the patient’s intake and output
7. Note the volume and character of urine and record observations
carefully
8. Teach the patient the importance of personal hygiene, especially the
importance of careful cleaning after having bowel movement and
thorough washing of hands frequently
9. Report any signs of infection promptly. These include a burning
sensation and irritation at the meatus, cloudy urine, a strong odor to
the urine, an elevated temperature and chills
10. Plan to change indwelling catheters only as necessary. The usual
length of time between catheter changes varies and can be anywhere
from 5 days to 2 weeks. The less often a catheter
Removing the Indwelling Catheter and Aftercare of the Patient
1.Be sure the balloon is deflated before attempting to remove the catheter.
This may be done by inserting a syringe into the balloon valve or by cutting the
balloon valve.
2.Have the patient take several deep breaths to help him relax while gently
removing the catheter. Wrap the catheter in a towel or disposable, waterproof
drape.
3.Clean the area at the meatus thoroughly with antiseptic swabs after the
catheter is removed.
4.See to it that the patient’s fluid intake is generous and record the patient’s
intake and output. Instruct the patient to void into the bedpan or urinal.
5.Observe the urine carefully for any signs of abnormality.
6.Record and report any usual signs such as discomfort, a burning sensation
when voiding, bleeding and changes in vital signs, especially the patient’s
temperature. Be alert to any signs of infection and report them promptly.
thank you
References:
https://nurseslabs.com/urinary-catheterization-nursing-proceduremanagement/
https://www.nhsinform.scot/tests-and-treatments/medicines-andmedical-aids/medical-aids/urinary-catheterisation/