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CATHETERIZING THE FEMALE URINARY BLADDER

1. Confirm physician orders


2. Identify the patient, discuss the procedure with the patient and
assess the patient’s ability to assist with the procedure
3. Bring catheter tray to bedside.
4. Perform hand hygiene
5. Close door and curtains around the bed. Provide good lighting
6. Raise the bed to a comfortable working height. Stand on the right
side if you are right handed, left side if you are left handed
7. Assist patient to a dorsal recumbent position with knees flexed, feet
about 2 feet apart, and legs abducted. Drape the patient with the
sheet
8. Put on clean gloves. Cleanse the perineal area with soap and water.
Remove gloves, perform hand hygiene again.
9. Open sterile cath tray on clean overbed table using sterile technique
10. Put on sterile gloves. Grasp upper corners of rectangular drape and
fold back each corner to make a cuff over gloved hands. Ask patient
to lift her buttocks and slide sterile drape under her.
11. Remove first pair of sterile gloves and discard. Don new sterile gloves
from kit.
12. Place fenestrated sterile drape over the perineal area, exposing the
labia
13. Open all supplies in kit. Test balloon on catheter by removing
protective cap on tip of syringe and attaching syringe prefilled with
sterile water to injection port. Inject all 10 ml of fluid. If balloon
inflates properly, withdraw fluid and leave syringe attached to port
14. Fluff cotton balls in tray and pour antiseptic solution over them
15. Open lubricant and place in tray
16. Move and place sterile tray on drape between patient’s thighs
17. Lubricate 1” to 2” of catheter tip
18. With thumb and one finger of nondominant hand, spread labia and
identify meatus. (Once you have touched the patient’s perineum that
hand is no longer ‘sterile’!)
19. Use dominant hand to pick up cotton balls with provided tweezers.
Clean one labial fold, top to bottom ONCE then discard. Use a new
cotton ball, clean other labial fold ONCE then discard. Use a new
cotton ball and clean down the center. Optional—use a fourth cotton
ball and touch once directly over meatus to facilitate visualization.
20. Using your dominant hand, hold catheter 2” to 3” from the tip and
insert slowly into the urethra. Advance catheter until there is a
return of urine (approx. 2-3”). Once urine drains, advance catheter
another 2” to 3”. DO NOT force catheter through urethra into
bladder. Ask patient to breathe deeply and rotate catheter gently if
slight resistance is met as catheter reaches external sphincter.
21. Hold catheter securely at the meatus with your non dominant hand.
Use dominant hand to inflate catheter balloon. Inject entire volume
supplied in prefilled syringe. Keep plunger depressed!
22. Pull gently on catheter with non dominant hand after balloon is
inflated to feel resistance.
23. Remove syringe from tubing by using non dominant hand to hold onto
“collar” and dominant hand to remove syringe
24. Obtain urine specimen within first 15 minutes if ordered.
25. Remove equipment and dispose of properly.
26. Remove gloves. Secure catheter tubing to patient’s inner thigh;
remember to leave some slack in the tubing.
27. Catheter tubing goes OVER the leg, cover the patient with linens.
28. Return bed to lowest position and secure drainage bag below the level
of the bladder.
29. Assist the patient to a comfortable position
30. Perform hand hygiene
31. Chart procedure in nurses’ notes