CATHETERIZATION

Present By: Ma Cristina M. Vargas

(BSN2) BLOCK D
Catheterization
• is a thin tube made from
medical grade materials
serving a broad range of
functions. Catheters are
medical devices that can
be inserted in the body to
treat diseases or perform a
surgical procedure.
 DEFINITION
• Catheterization of the urinary bladder is the
insertion of a hollow tube through the urethra into
the bladder for removing the urine. It is an aseptic
procedure for which sterile equipment is required.
PURPOSES OF URINARY CATHETERIZATION
• Relieve Urinary Retention.
• Obtain a Sterile Urine specimen
from a female patient.
• Measure Residual Urine.
• Empty the bladder Before,During,or
After Surgery.
• Allows accurate measurement of
urine output.
 URINARY CATHETER SIZES
• The French scale (Fr)is used to denote the size of catheters. Each unit is
roughly equivalent to 0.33 mm in diameter (that is, 18 Fr. Indicates a
diameter of 6 mm).
• The smaller the number, the smaller the catheter. A larger sized catheter
is used for a male because its stiffer, thus easier to the distance of the
male urethra.

• Catheters come in several sizes:

- a. Number 8 Fr. and 10 Fr. are used for children
- b. Number 14 Fr. and 16 Fr. are used for female adults
-c. Number 20 Fr. and 22 Fr. are usually used for male adults
TYPES OF URINARY CATHETERS

• Intermittent Catheter-
An Intermittent Catheter is used to
drain the bladder for short periods (5-10
minutes). It may be inserted by the
patient.
• Retention/Indwelling Catheter-
This type of catheter is placed into the
bladder and secured there for a period of
time.
• 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 .
>Condom Catheter
A condom catheter is a male external catheter made up of
silicone or latex or sheath, worn by men just like condoms to
collect the urine which the bladder drains out. After collecting
the urine from the bladder, it is sent to the drainage bag
attached to the person.
>Silicon Catheter
The 100% Silicone catheter is a urinary catheter made
entirely out of silicone. They contain no latex, which makes
them ideal for people with latex allergies or sensitivities.
100% Silicone catheters come in many different types and
styles, including Foley, intermittent, and coude tip catheters.
 PREPARING FOR CATHETERIZATION
• A catheter should be used only when absolutely necessary and the
catheterization procedure itself should be done only by trained personel
under sterile conditions. Infection is a major risk of urinary catheterization.
Gather All Equipment:
- Catheter
- 10cc syringe
- sterile water
- Cotton balls with betadine
- Lubricant
- Sterile gloves
- flashlight or lamp
- Urine collection bag
- Velcro leg strap or anchoring tape
- Disposal bag
• Explain the procedure to the patient.
• Provide for Privacy and Adequate Lighting.
• Positioning
- Position the female patient in a dorsal recumbent psition with the knees flexed
and the feet about two feet apart.
- Position a male patient in a supine position. Drape the patient so that only the
area around the penis is exposed. Placed the catheter set next to the legs of the
male patient.
 INSERTING THE FOLEY CATHETER IN A MALE PATIENT
• Cleanse the genital and perineal areas with warm soap and water.
Rinse and dry.
• Wash your hands.
• Open the sterile catheterization kit, using sterile technique.
• Put on the sterile gloves.
• Open the sterile drape and place on the patient’s thighs, Place
fenestrated drape with opening on the penis.
• Apply sterile lubricant liberally to the catheter tip. Lubricate at least
six inches of the catheter. Leave the lubricated catheter on the sterile
field.
• Pour the antiseptic solution over the cotton balls.
• Place the urine specimen collection container within easy reach.
• Grasp the patient’s penis between your thumb and forefinger of your
nondominant hand. Retract the foreskin of an uncircumcised male.
The gloved hand that has touched the patient is now contaminated
• Use the forceps to hold the cotton balls. This will maintain the sterility of one hand. Using the
forceps, pick up one cotton ball and swab the center of the meatus outward in a circular
manner.
• Continue outward, using a new cotton ball for each progressively larger circle. Clean the
entire glands. Deposit each cotton ball in the disposal bag. After the last cotton is used, drop
the forceps into the disposal bag as well.

I. Hold the penis at 90-degree angle.

Advance the catheter into the patient’s urinary meatus.
You may encounter resistance at the prostatic sphincter.
1.Pause and allow the sphincter to relax.
2. Lower the penis and continue to advance the catheter.

NOTE: Never force the catheter to advance. Discontinue the

procedure if the catheter will not advance or the patient has
Unusual discomfort.
• When the catheter has passed through the
prostatic sphincter into the bladder, urine will start
to flow. Gently insert until 1 to 2 inches beyond
where urine is noted.
• Inflate balloon, using correct amount of sterile liquid
(usually 10cc but check actual balloon size)
• Gently pull catheter until inflation balloon is snug
against bladder neck.
• Connect catheter to drainage system
• Anchor the catheter tubing to the lateral
abdomen with tape, without tension on tubing
• Place drainage bag below level of bladder
• Evaluate catheter function and amount, color,
odor, and quality of urine
• Remove gloves, dispose of equipment
appropriately, wash hands
• Document size of catheter inserted, amount of
water in balloon, patient’s response to
procedure, and assessment of urine
INSERTING THE FOLEY CATHETER IN A FEMALE PATIENT

• Follow procedure same with male from step a-h

• Place the thumb and forefinger of your
nondominant hand between the labia minora,
spread and separate upward. The gloved hand
that has touched the patient is now contaminated.

• Using the forceps, pick up a cotton ball saturated

with antiseptic solution. Use one cotton ball for
each stroke. Swab from above the meatus
downward toward the rectum.

• Keeping the labia separated, cleanse each side of

the meatus in the same downward manner Do not
go back over any previously cleansed area.

• Deposit each cotton ball into the disposal bag.

After the last cotton ball is used, deposit the
forceps into the bag as well
• Continue to hold the labium apart after
cleansing. Insert the lubricated catheter into
the female patient’s urinary meatus.
• Angle the catheter upward as it is advanced.
If the catheter will not advance, instruct the
patient to inhale and exhale slowly. This may
relax the sphincter muscle. Do not force the
catheter.
• When urine starts to flow, insert the catheter
approximately one inch further. Place the cup
under the stream of flowing urine to obtain a
sterile specimen if required.
• Inflate balloon, using correct amount of sterile liquid (usually
10 cc but check actual balloon size)
• Gently pull catheter until inflation balloon is snug against
bladder neck
• Connect catheter to drainage system
• Connect the drainage bag to the catheter, Securer the
catheter to the inner aspect of the female patient’s thigh
• Place drainage bag below level of bladder
• Evaluate catheter function and
-amount, color, odor, and quality of urine
• Remove gloves, dispose of equipment
-appropriately, wash hands
• Document size of catheter inserted, amount of water in
balloon, patient’s response to procedure, and assessment of
urine
 REMOVING AN INDWELLING CATHETER
• Assemble all supplies and equipment.
(1) 10 cc syringe.
(2) Washcloth and towel.
(3) Exam gloves
(4) Soap and water
• Identity the patient and explain the procedure to him that there will be a
slight burning during removal of the catheter.
• Provide privacy and assist the female patient into a dorsal recumbent
position. The male should be in a supine position.
• Wash your hands and put on exam gloves.
• Empty the balloon by inserting the barrel of the syringe and widrawing the
amount of fluid used during inflation.
• Pinch off and gently pull on the catheter near the point where it exits from the
meatus.
• Clean the perineum or penis with soap and water. Dry the area well.
• Inspect the catheter to be sure no remnants remained in the bladder. If the
catheter is not totally intact, report this promptly and save the catheter for further
inspection.
• Empty the drainage bag. Measure the amount of urine and record on the intake
and output (I&0) sheet.
• Remove the gloves and wash your hands.
• Discard disposable supplies and return reusable supplies and equipment to the
appropriate area.
• Record that the catheter was removed, the time and date and by whom. Note the
amount, color, and clarity of the urine in the drainage bag. Also document all
patient teaching done and the patient’s level of understanding.
• After removal of the catheter, assess the patient for 24 hours for patterns of
urinary elimination. Note the time and amount of the first voided urine.
-Inability to void within 8 to 10 hours.
-Frequency, burning, dribbling, or hesitation in starting the stream of urine.
-Cloudiness or any other unusual color or characteristic of the urine .
-Provide a level of fluids similar to the intake when the catheter was in place.
-Record that the catheter was removed, the date and time, and by whom.