Types of Catheterization –
A Simple Nursing Procedure
Urinary Catheterization
Urinary catheterization is the introduction of a tube (a catheter) through the urethra into the urinary bladder to drain the bladder.
Purpose:
To get a sterile urine specimen for diagnostic purpose.
To empty the bladder when a condition of retension occurs.
To determine whether the failure to void is due to retension or suppression.
To measure the amount of urine for diagnostic purpose.
To empty the bladder prior to surgery involving rectum, vagina and pelvic organs.
To prevent urine in the perineal region.
To provide for bladder drainage and irrigation.
Types of Catheterization
Intermittent technique.
Indwelling or Foley catheter.
Intermittent Technique
A straight single use catheter is introduced for a period enough to drain the bladder. When the bladder is empty, the nurse immediately withdraws the catheter. This can be repeated when necessary.
Indwelling or Foley Catheter:
An indwelling catheter remains into the bladder, for an extended period until the client is able to void completely and voluntarily. If necessary, it can be changed periodically.
Size of Catheter:
The French system is used for catheter gauze sizing.
Children: No. 8 or No. 10 French.
Women: No. 14 t No. 16 French.
Men: No. 16 to No. 18 French.
General Instructions:
Avoid catheterization unless ordered.
Observe strict aseptic techniques to prevent UTI.
Always use a rubber catheter.
Never use force.
Always catheterize in sufficient light.
Clean the perineum for the pubis downwards to the anal region. Use one cotton ball for one swabbing.
Do not touch the part of catheter that is going into urinary tract.
Lubricate the catheter well.
Keep the patient relaxed by providing privacy and explaining the procedure.
Preliminary Assessment
Check physician’s order.
Identify the patient and purpose of catheterization.
Check the specific precautions if any.
Check the consciousness of the patient and the ability to follow instructions.
Check the general condition of the patient to maintain desired position.
Check the articles available in unit, and also availability of light.
Preparation of Articles:
Articles:
A sterile catheter
Purpose: to introduce into the bladder.
A small bowel containing dettol 2%.
Purpose: To clean the perineum.
Cotton swabs
Purpose: To clean the perineum.
Gauze Piece
Purpose: To hold the catheter and to separate the labia.
A pair of gloves
Purpose: To keep up the aseptic techniques.
Sponge holding forceps
Purpose: To hold the swabs to clean the perineum.
Kidney Tray
Purpose: To collect urine.
Specimen bottles
Purpose: To collect the specimens if ordered.
A small bowel containing liquid paraffin (Sterile)
Purpose: To lubricate the catheter.
Dressing towel and slit.
Purpose: To create a sterile field.
Syringe with distilled water, drainage tubing and collection bag.
Purpose: if any indwelling catheter is used.
An Unsterile Tray Containing:
Mackintosh and Towel – To protect the bed.
Kidney Tray and Paper bag – To collect the water.
Spot Light – To visualize the meatus.
Clean linen as needed – To change after the procedure.
Pint Measure – To Measure the urine.
Preparation of the client and unit:
1. Explain the procedure to the patient.
2. Adjust the position of the bed to the comfortable working of the nurse.
3. Move the client to the edge of the bed near to the nurse.
4. Place the client in dorsal recumbent position.
5. Cover the client with a sheet or bath blanket and fan fold the top linen to the foot end of the bed.
6. the mackintosh and towel under the client to protect the bed.
7. Arrange the articles conveniently at the bedside.
8. Focus the light source correctly.
9. Drape the client to provide privacy.
Procedure:
1. Scrub hands as for a surgical procedure.
2. Lift the draping sheet back towards the abdomen with the elbow to expose only the perineum.
3. Open the sterile tray with aseptic techniques. Put on the gloves.
4. Place the sterile towel and slit in position.
5. Place the sterile kidney tray on the sterile towel in front of the client. Lubricate the catheter and place it in the sterile tray.
6. Clean the perineum with the cotton balls dipped in antiseptic solution using the forceps.
Cleaning is done as follows.
Labia majora on both sides.
The inside of the labia majora on both sides.
The vulva.
Discard the articles in unsterile kidney tray.
7. Keep the labia separated and pulled upwards from the time the vulva is cleaned until the catheter is introduced.
8. Pick up the catheter with gloved hand holding it about 7.5 cm from the tip and place the distal end in sterile kidney tray.
9. Gently insert the catheter about 5 to 7.5 cm. The urine will flow into the kidney tray. If the urine does not flow, rotate the catheter.
10. Release the labia minora and hold the catheter with the same fingers. Until the indwelling catheter is inflated, maintain this position.
11. Collect the urine specimen if required. Attach the drainage tubing if indwelling catheter is put in.
12. When necessary remove the catheter slowly.