Republic of the Philippines

CAVITE STATE UNIVERSITY

Don Severino de las Alas Campus
Indang, Cavite
(046) 415-0010 / (046) 415-0011
www.cvsu.edu.ph
cvsu.op206@gmail.com

COLLEGE OF NURSING

FUNDAMENTALS OF NURSING
RELATED LEARNING EXPERIENCES

NAME: _________________________________________ DATE: ________________

YEAR AND SECTION: _________ GROUP No.: ___________

CHECKLIST ON URINARY CATHETERIZATION

Able to
Able to Unable to
perform with
PROCEDURE perform perform
assistance
(3) (1)
(2)
1. Verify order for catheter insertion
2. Review patient record for any latex allergy

3. Explain the procedure to the patient and provide

privacy. Consider age, cultural and religious
influences and educational level when explaining
and performing the procedure.
4. Gather all the equipments needed and wash hands
prior to the procedure
5. Position the patient properly:

Female: Supine position with knees flexed and

separated; feet flat on the bed.

Male: Supine position with legs extended.

6. Cleanse the perineal area with soap and water and
dry.
7. Create an area for the sterile field and open
packaging.
8. Drape the patient with sterile drapes supplied in the
kit.
9. Don sterile gloves.
10. Saturate cotton balls with iodine solution. (Ensure,
patient is not allergic to iodine).
11. Open the packet of water-soluble lubricant and
lubricate the catheter tip.
12. Ensure emptying port of the drainage bag is
closed.
13. Prepare the insertion site in a sterile fashion.

Female: Separate the labia with non-dominant hand

and keep open during entire cleansing process. With
dominant hand, cleanse with iodine-soaked cotton balls
before cleansing. Maintain separation of labia.

Male: If the patient is uncircumcised, retract the foreskin

before cleansing. Hold the penis with non-dominant
hand, stretching it to a 60 to 90 degree angle. With
dominant hand, cleanse with iodine-soaked cotton balls,
using a circular motion, starting at the meatus and
working outward.
14. With dominant hand, while holding the remainder of
the catheter so that it does not touch anything but a
sterile field, grasp the end of the catheter.
15. Insert the catheter into the n=urinary meatus until
urine is returned.

Female: Approximately 2 – 3 inches.

Male: Approximately to the bifurcation of the

catheter.
16. Stop advancement is resistance is met. Notify the
physician.
17. Female: If the catheter is inadvertently inserted into
the vagina, leave the catheter in place until another
insertion kit can be obtained.
18. Attach the saline-filled syringe and inflate the balloon
if indwelling catheter.
19. Hang the collection bag below bladder level.
20. Secure Catheter drainage tubing to the patient’s
thigh or use a leg band with Velcro closure to
prevent pressure on the urethra.
21. Remove equipment and dispose of used supplies.
22. Cover patient to restore privacy
23. Wash hands after disposing the used materials.
24. Document the procedure and patient tolerance to it;
catheter size, amount, color, clarity of urine; and any
specimen(s) sent to the laboratory.
Total Score:
Remarks:

___________________________ ___________________________________
Student’s Name and Signature Clinical Instructor’s Name and Signature