outlines

Objectives

purpose of urinary catheterization

indications

 contraindications

necessary equipment for catheterization

procedure of urinary catheterization

summary
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Objectives
After completion of this session, you will able to:

 Define urinary catheterization

 List the purpose of urinary catheterization

 Identify indications and contraindications

 List the necessary equipment for catheterization

 Perform procedure of urinary catheterization

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 Urinary catheterization

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04/01/2021 Desalew Tilahun 4
Urinary catheterization
The introduction/insertion of a catheter/tube via the
urethra into the urinary bladder.

A catheter is made of ; plastic, Latex(rubber) or Silicon

used for injecting or removing fluids from the body.

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Urinary catheterization cont’d…
Types of catheter

Catheters came in different size and

types.
The most common types of catheter are
Indwelling or retention catheter
Straight or plain catheter

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Urinary catheterization cont’d…
A) Indwelling catheter

It also called retention or Foley catheter.

Two way or three way catheter

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Urinary catheterization cont’d…

Indwelling catheter can be differ in the

number of lumens
Double lumen catheter- has two lumens
One lumen is used to inflate balloon at the end of the catheter
The other lumen is to drain urine.

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Urinary catheterization cont’d…
Triple lumen catheter – has three
lumens.
One lumen drains the urine.
The second lumen holds the sterile water when the
catheter is inflated .
The third lumen maybe used to instill medications
into the bladder or provide bladder irrigation.

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Urinary catheterization cont’d…
Indwelling catheters are used for:

Gradual decompression

Continuous bladder drainage

Intermittent or Continuous bladder irrigation

Instillation of medication

prevent infection

Provide a means to monitor accurate urine output

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Urinary catheterization cont’d…

For an accurate measurement of urinary out put

Empty the bladder before, during, or after Surgery.

In case of retention due to injury or tumor of the spinal cord

To obtain sterile specimen of urine

 To ensure that the bladder is empty before an abdominal or

pelvic operation or Paracenthesis.

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Urinary catheterization cont’d…

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Urinary catheterization cont’d…
B) Intermittent or straight catheter

is a single lumen tube with a small

opening in the insertion tip.

A catheter used to drain urine for shorter

period of time

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 Urinary catheterization cont’d…

Intermittent catheters used for:

 Relieving discomfort due to bladder distension

Assess the residual urine

Obtain a urine specimen(about 30ml)

Empty the bladder prior to surgery

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Urinary catheterization cont’d…

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Urinary catheterization cont’d…
C) Suprapubic catheterization
It is inserted through a small incision above
the pubic area directly into the urinary
bladder.

Used for
After gynecologic or other abdominal surgery
Occasionally after pelvic fractures

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Supra Pubic Catheter

This type of catheter is inserted into

the bladder through a small incision
above the pubic area.
It is used for continuous drainage.

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 Urinary catheterization cont’d…
Sizes of catheters
Catheters are sized in units called French.

Diameters:

5Fr, 6fr, 8fr 10fr, 12fr, 14fr, 16fr, 18fr, 20fr, 22fr, 24fr,
26fr.

Higher the number, the larger the diameter.

1Fr. = 1/3mm (i.e. a 24fr. catheter is 8mm in diameter)

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 Urinary catheterization cont’d…
Choosing the appropriate catheter depends on:

The size of the patient’s urethral canal

 # 8 -12 Fr – children
 # 14 and 16 Fr – adult female
 # 18 - 24 Fr – adult male

The expected duration of catheterization

 Plastic – for 1 week
 Latex (rubber)– for 2-3 weeks
 Silicon – for 2-3 month

Knowledge of any allergies to Silicon ,latex or plastic.

The indications for catheterizing the patient

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 Indications

neurological condition or injury

outlet obstruction

Palliative care

Chronic urinary retention

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 Contraindications
Urethral trauma

Pelvic fracture

Scrotal hematoma

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 Urinary catheterization cont’d…
Inserting a Retention (Indwelling) Catheter

Equipments
Sterile Set
Appropriate size Catheter 1 forceps in Sterile urine receptacle
(KD)
2 Sterile drapes (fenestrated & 10 cc Sterile water in galipot
square drape) Syringe (usually 10 cc)
Sterile gauze Galipot
14 Cotton swabs Sterile gloves
6 forceps in kidney dish Specimen container (bottle)
Receiver (kidney dish)

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 Urinary catheterization cont’d…

Clean Set
Rubber sheet
Cleansing solution (sterile
Lubricant ((KY-jelly)
NS)
Tape(Catheter-secure device)
Urine collection bag & tubing
Disposable gloves
Bed screen Bath blanket
Soap and 3 washcloths
Warm water in basin
Towel

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 Performing Urinary Catheterization:
Procedure
1. Explain procedure to the patient.
2. Wash hands, gather equipment and bring to the bed
side.
3. Provide privacy by applying bed screen.
4. Adjust the bed to a comfortable height and apply bath
blanket.
5. Place the pt in an appropriate position
 Male: supine position with legs slightly spread and feet
together or dorsal recumbent position.
 Female: dorsal recumbent or side laying position

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 Procedure…
6. Don disposable gloves and wash perineal area (if not
did).
7. Remove disposable gloves.
8. Hang the urinary drainage bag on the side of the
bed and place below the level of bladder.
9. Open the sterile field and:
 Pour cleansing solution in one galipot
 Place lubricant in one sterile gauze
 Open the Foley catheter and place it on the sterile field (if
not placed)

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Procedure…..
10. Apply sterile gloves and fill the syringe with sterile
NS (10ml) from galipot.
11. Check balloon for any leakage and symmetry then
deflate and leave the syringe attached.
12. Lubricate 2.5-5 cm of the catheter tip and place on
the sterile urine receptacle (kidney dish).
13. Place square (un-fenestrated) drape b/n thighs or
under pt hip.
14. Place sterile supplies on the sterile square drape.

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 Procedure…..
15. Clean the area with 7 swabs and 3 forceps in zigzag fashion.
1. Pubic area
2. Rt groin
3. Lt groin
 Use one forceps for step 1, 2, and 3.
4. Rt labia (Peri-urethral mucosa)
5. Lt labia
 Use one forceps for step 4 and 5.
6. from urethral orifice to vaginal orifice
7. from urethral orifice to anal orifice
 Use one forceps for step 6 and 7.

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 Procedure…..

16. Drying the area using 7 dry cotton balls and 3 forceps
in the same way of cleansing.

17. Place fenestrated drape on the client’s abdomen and

thighs.

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 Procedure…..
18.Pick up and hold end of catheter loosely
coiled in palm of dominant hand (still
sterile).
19.Expose the urinary meatus adequately
by:
 Male: holding the penis perpendicular using non-dominant
hand.
 Female: separate labia using non-dominant hand.
20.Identify the urinary meatus and gently
insert:
 5cm in females and 20cm in males or
 Until urine comes. 29
Procedure…
21.Clamp the drainage lumen and inflate the
balloon using 10cc sterile NS.
22.Instruct the client to immediately report
discomfort or pressure during balloon
inflation; if pain occurs:
 deflate the balloon
 insert the catheter farther into the bladder (1-2 inch)
 inflate the balloon again
23. Gently pull the catheter until the retention balloon
is snagged against the bladder neck (resistance will
be met).

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 Procedure…..
24. Remove the fenestrated drape.

25. Connect the catheter with drainage bag tube.

26. Secure the catheter to the abdomen or inner thigh using tape.

27. Clean the perineal area using corners of sterile square drape
to remove lubricant and remove gloves.

28. Reposition the pt and return the bed to lowest position.

29. Wash hands ,assess and, document the amount, colour,

odour, and quality of urine.
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Urinary catheterization cont’d…

Note:
Never inflate a balloon before establishing that the
catheter is in the bladder
If the patient reports discomfort, withdraw the fluid
from the balloon and advance the catheter a little further,
then re-inflate the balloon.
If resistance is met: Pause for 10-20 seconds. Instruct
the patient to breathe deeply and evenly.
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 Prevention of infection

Cleansing the urethral area

clean hands

Disconnecting drainage bag as seldom as possible.

Keeping drainage bag connector as clean as possible

Use of a thin catheter.

Drinking sufficient liquid to produce at least two liters of urine

daily

Sexual activity is very high risk

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Reading assignment on

 General Care of Patient

 Applying a Condom Catheter

 Bladder Irrigation (open and closed method)

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References

 Health F, Student S. In collaboration with

AIDSTAR-One : Ethiopia.

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 summary

1. Define urinary catheterization

2. List the purpose of urinary catheterization

3. Identify indications and contraindications

4. List the necessary equipment for catheterization

5. Perform procedure of urinary catheterization

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 .
.

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