Plan of Nursing Service
100.111
Date:
Consumer:
Diagnosis: Suprapubic Catheters
Diagnosis Description: A suprapubic catheter is a bendable rubber tube that is inserted
directly from your abdomen into your bladder to drain urine. A suprapubic catheter may
be used in conditions were there is a problem passing urine.
How to clean the skin around suprapubic catheter:
The opening created for the suprapubic catheter is called a stoma. Clean the skin around
the stoma every day unless otherwise specified by an MD. The following directions for
cleaning the skin around the stoma:
Gather all the items you will need:
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Warm water and soap without lotions or perfumes in it.
Clean washcloth or sterile gauze bandage
Clean towel
New gauze bandage
Sterile (clean) medical gloves
Trash can
Remove the bandage and look at the site:
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Wash your hands using soap, or use a hand cleaner. Put on clean gloves.
Gently remove the bandage. Do this by supporting the skin around the
stoma with one hand. With the other hand, gently remove any adhesive tape
by pulling in the direction of hair growth. Throw the bandage away in the
trash can.
Look for problems such as redness, separation of skin/tears, red spots and
swelling. Report any skin changes to the nurse. Throw away used gloves.
Wash hands and put on clean gloves.
Clean the area with warm water:
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Hold the end of the catheter tube in place to keep it from being pulled out
while cleaning.
Wash the catheter to remove blood or other material, moving away from the
stoma.
Rinse the stoma and the skin around it in a circular motion, moving away
from the stoma.
Pat the area gently with a clean towel to dry it.
Plan of Nursing Service
100.111
Date:
Consumer:
Diagnosis: Suprapubic Catheters Continued
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Throw away your used gloves. Wash your hands, and put on clean gloves. If
you use a bandage, apply a new one.
Loop the catheter tubing and secure it well. Avoid kinking or blocking the
tubing. Throw away your used gloves. Wash your hands.
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How to empty the urine drainage bag:
Empty the urine drainage bag after measuring the consumer’s output. Empty the
bag when it is one-half to two-thirds full. Empty a full sized drainage bag every 8
hours. If you have a smaller leg bag, empty it every 3 to 4 hours. Do the following
when emptying the consumer’s urine bag.
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Place a large container on the floor next to the consumer’s chair.
Remove the drain spout from its sleeve at the bottom of the urine bag
without touching the tip.
Let the urine flow out of the bag into the container. Do not let the drainage
tube touch anything.
Clean the end of the drain spout when the bag is empty. Use an alcohol
swab to wipe the end off.
Close the drain spout. Write down how much urine was in the bag.
How to clean the urine drainage bag:
Clean your reusable urine drainage bag at least once a week. After detaching the
used drainage bag from the catheter tubing and replaced with a new bag, do the
following:
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Drain any urine out of the used drainage bag.
Rinse the used drainage bag with warm water.
Fill the bag with one part vinegar to three parts water. Let the bag sit with
the water and vinegar for 30 minutes.
Empty, rinse, and air-dry the urine drainage bag.
When the bag is dry, store it in a clean plastic bag until you are ready to use
it again.
Plan of Nursing Service
100.111
Date:
Consumer:
Diagnosis: Suprapubic Catheters Continued
When to call the nurse:
Signs or symptoms of a urinary or bladder infection-not much output, fever, pain
(groaning/lethargy/not acting self). Blood in the urine could be a sign of a kidney
stone.
What you can do to prevent problems with the suprapubic catheter:
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Check the catheter to be sure it is in place after changing clothes or other
activity. Avoid tight clothing over the tubing or catheter. Position the
tubing over consumer’s thigh rather than under it when sitting.
Keep the urine bag below the level of the bladder (below waist level). This
will prevent urine from flowing back into the consumer’s bladder from the
tubing and urine bag. Backflow of urine can cause infection. Never raise
the drainage bag above the stomach. Keep the tubing below the level of the
bladder, but above the level of the bag.
Keep a closed drainage system. Avoid detaching the tubing from the
drainage bag unless you are changing the drainage bag to clean it or throw
it away. During the day, you may use a leg bag or smaller drainage bag.
Keep extra catheter supplies in the house.
Secure the catheter well. Catheters that are not secured will pull at the
insertion site. This causes the stoma to get bigger and the urine may start
leaking out of the stoma.
Wash your hands before and after catheter care. Use germ-killing soap
and warm water to wash your hands. You may also use germ-killing hand
washing gel. Put on a new pair of gloves when doing catheter care.
Do not place the drainage bag on the floor. When hanging a drainage bag,
keep the tubing straight line rather than coiled to prevent it from getting
blocked.
Do not reuse single use (disposable) catheter supplies. Throw single use
supplies away.
Plan of Nursing Service
100.111
Date:
Consumer:
Diagnosis: Suprapubic Catheters Continued
How to check if there is a problem with the catheter:
No drainage output from the catheter for 6-8 hours is a sign that may mean your
catheter is not draining urine from the bladder. Other signs include having a wet
bed or clothing. The consumer seems restless or in pain or distension in lower
abdomen region can also be signs of trouble. If the consumer has any of these
symptoms:
 Check to see if the urine tubing is twisted or bent or the consumer is sitting
or lying on the catheter or tubing.
 Make sure the urine bag and tubing are located below the level of the
consumer’s bladder.
 Move the consumer to a different position.
 If there is still no urine draining or the consumer continues to be restless, in
pain or shows distension, call nursing or on call right away.
When should I call Nursing or on call:
 Call if any signs of infection. These signs include fever, hip or stomach
pain, tremors (not normal for consumer). Changes in urine looks or smell,
or unexplained mood or behavior changes may also be signs of infection.
 Call if drainage bag color changes. Although color changes may be caused
by medicine or foods, call the nurse or on call to report color changes of
drainage in bag.
 If the catheter comes out. Cover the area with a sterile bandage while
calling nurse or on call.
Medications must be administered exactly as the physician ordered and as outlined
on the MAR.
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Date Reviewed by RN and Comments:
_______________________________________________________________________
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If any event causes concern for the well-being or safety of the
consumer, call nursing.
If any event occurs that is a threat to the safety or well-being of the
consumer call 911.