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Catheterization

Maige Charles

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Students learning tasks

  • By the end of this session, students are expected to be able to:
  • Identify the common terms used catheterization
  • Explain the purpose of catheterization
  • Demonstrate the procedure of catheterization

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Common Terms Used in catheterization

  • Catheterization is the procedure of introducing rubber or plastic tube through the urethra into the urinary bladder
  • Catheter is the plastic or rubber tube used for the procedure.
  • Intermittent catheters or straight catheters is the type of catheter which is placed into the bladder for short time 5 to 10 minutes
  • Indwelling/Retention or Foley catheter is the type of catheter placed into the bladder for extended period of time, have balloons at the distal end that is inflated after insertion

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Purpose of catheterization

  • To relieve acute or chronic urinary retention
  • For helpless patients
  • To empty bladder before, during and after surgery.
  • To instill medications into the bladder
  • To irrigate the bladder
  • To obtain urine specimen for diagnostic purposes.

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Procedure of Catheterization

  • Assessment
  • Assess bladder fullness before performing procedure
  • Ask patient about any allergies, especially to latex and iodine.
  • Ask patient if has been catheterized, if yes, ask why and for how long it was used. The patient may have urethral strictures that may cause insertion more difficult

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Equipment:

  • Sterile gloves
  • Sterile drapes
  • Cleansing solution e.g. Savlon
  • Cotton swabs
  • Forceps
  • Sterile water (usually 10 cc)
  • Foley catheter (usually 16-18 French)
  • Syringe (usually 10 cc)
  • Lubricant (water based jelly or xylocaine jelly)
  • Collection bag and tubing

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Steps:

  • Explain procedure to the patient
  • Gather equipment.
  • Screen the bed for privacy
  • Assist patient into supine position with legs spread and feet together
  • Open catheterization kit and catheter
  • Prepare sterile field, put on sterile gloves

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  • Check balloon for patency.
  • Generously coat the distal portion (2-5 cm) of the catheter with lubricant
  • Apply sterile drape
  • Using dominant hand to handle forceps, cleanse peri-urethral mucosa with cleansing solution. Cleanse anterior to posterior, inner to outer, one swipe per swab, discard swab away from sterile field.

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  • If female, separate labia using non-dominant hand. If male, hold the penis with the non-dominant hand. Maintain hand position until preparing to inflate balloon.
  • Pick up catheter with gloved (and still sterile) dominant hand. Hold end of catheter loosely coiled in palm of dominant hand.
  • In the male, lift the penis to a position perpendicular to patient's body and apply light upward traction (with non-dominant hand)
  • Identify the urinary meatus and gently insert until 1 to 2 inches beyond where urine is noted

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  • 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
  • Secure catheter to abdomen or thigh, without tension on tubing

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  • 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

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