CATHETERIZATION

Definition:

– the introduction of a catheter into a body cavity or organ to inject or remove fluid. The most common
procedure is the insertion of catheter into the bladder through the urethra for the relief of urinary retention
or emptying bladder before the surgery.

Purpose:

1. Prevent or relieve over distention owing to patients inability to urinate.

2. Empty the bladder as:

 Prevention of complication when voluntary urination is C/I.

 Prior to instillation, irrigation, operation or delivery

3. Secure urine for analysis and culture

4. Remove residual urine
5. Manage incontinence when all other measures have failed.
6. Provide for intermittent/ continuous bladder drainage and irrigation.
7. Prevent urine from contacting an incision after perineal surgery.
8. Empty the bladder completely before the surgery to prevent injury to other organs.
9. To assess the amount of residual urine if the bladder empties incompletely.
10. To facilitate accurate measurement of urinary output for critically ill patients whose outputs need to
be monitored hourly.

Principle:

1. Do medical handwashing

2. Always observe body mechanics

3. Provide privacy to the patient

 INDICATIONS

 Comatose patient
 Amputated patients
 Patient who will undergo surgery

PROCEDURES FOR PERFORMING FEMALE CATHETERIZATION

PROCEDURE RATIONALE

1. Verify the doctor’s order. Identify the patient and explain - To avoid any complications during the procedure.
the procedure. - To reduce the anxiety of the patient and to gain its
cooperation.

2. Get the tray, wash your hands, and then check the tray - Placement of equipment near the work site increases
for the needed articles. Open the tray using the aseptic efficiency. Sterile technique protects the patient and
technique. prevents the spread of microorganisms.

- This to clean the area to reduce the risk of acquiring a

3. Saturate the cotton balls with aseptic solution. catheter associated infection.

- It is necessary to open all supplies and prepare for the

4. Remove the catheter aseptically from the bag container. procedure while both hands are sterile.
Place it in the sterile tray and drop enough amount of KY
jelly. Close the tray and carry it to the bedside. - Sterile technique protects the patient and prevents the
spread of microorganisms.

5. Provide privacy. Place the rubber sheet and draw sheet - Ensuring privacy can promote more effective
under the patient’s buttocks. communication between physician and patient

- To protect the patient’s dignity.

6. Place the patient in dorsal recumbent position. Do the - Patient should be comfortable, with perineum or penis
diagonal draping. For the female patient, check if she exposed, for ease and safety in completing procedure.
needs preliminary care.
 Give the bedpan and do perineal care/flushing
 Remove the bedpan.

- Sterile tray will collect urine once catheter tip is inserted

7. Place the tray between the thighs facing the vulva into bladder.

- Adequate lighting helps with accuracy and speed of

8. Adjust the light. Place the waste receptacle at a catheter insertion.
convenient area.
- Adequate lighting helps with accuracy and speed of
catheter insertion.

- This provides easy access to supplies.

9. Open the tray by bringing the edge of the cover under the
buttocks.

- This reduces the transfer of microorganisms.

10. Put on gloves.

- The principle to remember is sterile to sterile.

11. Drape the patient with catheterization sheet.

- This reduces the transmission of microorganisms.

12. FOR FEMALE PATIENT: Disinfect the area using the
sterile procedure. Clean it with cotton balls with antiseptic
solution in the following order: URINARY MEATUS,
FARTHER FROM THE LABIA MINORA, NEARER THE
LABIA MINORA, FARTHER FROM THE LABIA
MAJORA, NEARER THE LABIA MAJORA, THEN THE
 URINARY MEATUS (CENTER) and ALWAYS WITH
ONE DOWNWARD STROKE.

FOR MALE PATIENT: Keep the skin foreskin retracted. Wash

off the glans penis around the urinary meatus with cotton balls
soaked in an antiseptic solution using the forceps to hold the
cleansing sponger cotton balls. (DISINFECT STARTING
FROM THE URINARY MEATUS GOING OUTWARD)

13. Place the kidney basin or bowl near the the patient’s - Urine specimen may be required for analysis. Collect as
buttocks. per agency policy.

14. Lubricate the catheter about 2 inches from the tip for the - Lubrication minimizes urethral trauma and discomfort
female patient, about 6-10 inches for the male patient. during procedure.

15. Place the end part of the catheter inside the bowl before
inserting the tip into the meatus. - To catch the urine

16. For the FEMALE PATIENT: Separate the labia minora to

expose the meatus and insert the catheter into the
urethra about 2-3 inches or until the urine flows.

- This process helps visualize urethral meatus and relax

For the MALE PATIENT: Grasp the shaft of the penis (with the external urinary sphincter.
left hand) raising it almost straight up and insert the catheter
into the urethra 6-10 inches or until the urine flows.
17. If the catheter is not to be indwelled (IF YOU ARE USING
A STRAIGHT CATHETER), pinch the catheter and
remove it slowly as soon as the desired specimen is
obtained or until the urine increases to flow. - The size of balloon is marked on the catheter port.

DRY THE VULVA WITH SPONGE USING THE FORCEPS

- Cleaning removes any secretions, urine, and feces, and

REMOVE THE GLOVES AND THE CATHETERIZATION reduces risk of CAUTI.
SHEET AND PLACE THEM ON A TRAY.

- This reduces the transmission of microorganisms.

18. FOR INDWELLING (IF YOU ARE USING THE FOLEY

BAG CATHETER) INJECT THE NEEDED AMOUNT OF
DISTILLED WATER WITH THE USE OF A SYRINGE TO
INFLATE THE BALLOON (AS INDICATED BY THE - Urinary bag should be closed to prevent urine drainage
MANUFACTURER’S INSTRUCTIONS) leaving bag.

19. Turn off the light. Undrape the patient. Remove the rubber
sheet and remake the top sheet.

- To protect the patient’s dignity.

- To avoid further contamination.

20. Remove the screen and open the windows. Bring all the
equipment to the utility room.

- This reduces the transmission of microorganisms.

21. Wash all the equiment with soap and water. (return to
CSR). Return the rest of the equipment in their proper places.

- For future use purposes.

23. CHART: time of procedure, amount of urine, character of

urine whether the urine is sent to the laboratory, specify if
indwelled and the reaction of patient.

- Timely and accurate documentation promotes patient

safety.

- A careful record is important for planning the patient’s

care.