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College of Nursing
Faculty Meeting
AVR 2 A & B
1:30AM, August 3, 2024
Assisting in Catheterization
 OBJECTIVES:
• To relieve discomfort due to bladder distention or to provide gradual
decompression of a distended bladder
• To assess the amount of residual urine if the bladder empties incompletely
• To obtain a sterile urine specimen
• To provide for intermittent or continuous bladder drainage and/or irrigation
• To obtain a urine specimen when a specimen cannot be secured satisfactorily
by other means. Examples include collecting an uncontaminated specimen
from a woman who is menstruating or from an incontinent patient
 OBJECTIVES:
• To empty the bladder prior, during, or after the surgery, or before certain
diagnostic procedures
• To facilitate accurate measurement of urinary output for critically ill clients
whose output needs to be monitored hourly
• To prevent urine from contacting an incision after perineal surgery
• To manage incontinence when other measures have failed.
GENERAL CONSIDERATIONS
• Identify status of patient for
appropriate preparation of catheter
size.

• Follow proper hand washing

techniques.
GENERAL CONSIDERATIONS
Do not allow the spigot on the drainage bag
to touch a contaminated surface.

Do not open the drainage system at

connection points to obtain specimens or
measure urine.
GENERAL CONSIDERATIONS
• If the drainage tubing becomes disconnected, do not touch
the ends of the catheter or tubing. Wipe the ends of the
tube with an antiseptic solution before reconnecting.
• Prevent pooling of urine and reflux of urine into the
bladder.
• Remove the catheter as soon as possible after conferring
with the physician
Catheterization

- they are also called indwelling catheters.

- Catheter - is a thin, clean hollow tube which is usually

made of soft plastic or rubber.
 Types of Catheterization
• Foley catheter/indwelling urethral
catheter/retention catheter - used if the
catheter is to remain in place for
continuous drainage
a. In a double-lumen catheter

b. The triple-lumen catheter

Types of Catheterization
• Intermittent catheter/straight catheter has a
single lumen. It is used to drain the bladder for
shorter periods (5-10 minutes).
 • Spinal cord injury & Pelvic nerve
damage
Indication • Neuromuscular degeneration
for Foley • Incompetent bladder
• Prostate enlargement
Catheter • Clients undergoing surgical repair of
the urethra and surrounding
structures
• Critically ill or comatose client
 • Urinary retention with recurrent
episodes of Urinary Tract Infection
Indication • Clients with skin rashes, ulcer or
wounds irritated by contact with urine
for Foley • Pre-operative/post-operative client
• Pre-partum/post-partum client
Catheter • Urinary incontinence
 • Catheterization tray
▪ sterile gauze (2)
Equipment ▪ sterile bowl
▪ sterile towel with hole (male)
Needed for ▪ pair of sterile gloves
Foley • flashlight/lamp (optional)
• indwelling catheter / foley catheter – specific
Catheter size: male (16-18 french) female (12-14
french)
insertion • drainage bag and tubing
• water soluble lubricant (K.Y. jelly)
 • syringe prefilled with sterile water in
Equipment amount specified by catheter
manufacturer (minimum of5 ml to
Needed for maximum of 10 ml specified)
Foley • sterile specimen container (if needed)
• flushing tray
Catheter • Bedpan
insertion • 2% Xylocaine gel (if agency permits)
• waste receptacle
 • Obtain a doctor's order and
What to check the Nurse's record.
• Rationale: To make sure that you will
Consider perform correct procedure for the right
Before patient.

Catheter • Bring the Equipment Needed to

the bedside.
Insertion • Check if there is a proper light
inside the room.
• Rationale: Good lighting is necessary to
see the meatus clearly
 • Identify the client and explain
the procedure and
Straight its purpose
• Rationale: An explanation encourages
Catheter patient cooperation and reduces
apprehension

• Provide for privacy by closing

the curtains or door
• Rationale: The procedure may be
embarrassing for the client
 • Assist client in the appropriate position.
a. Female: Supine with the knees flexed and
the feet about 2 feet apart and drape the
client. Or if preferable, the client can be
Straight placed in the side-lying position.
b. Male – supine, thighs slightly abducted or
Catheter apart.

Rationale: Good visualization of the meatus is

important. Embarrassment, chilliness, and feeling tense
can interfere with introducing the catheter. The patient’s
comfort will promote relaxation.
 • Lower side rails on the working side
Straight Rationale: Promotes the use of proper body
Catheter mechanics
• Drape the client with the top sheet.
• Female
• assist the client to side near you
• loosen the foot part of the top sheet
• use diagonal draping
• Male
• expose only the penis and a
small surrounding area
Rationale: To avoid unnecessary exposure
 • Provide perineal care if needed. Perform
proper hand washing again.
Rationale: Clean technique decreases the
possibility of introducing organisms into the bladder
Straight • Place catheter tray between thighs
Rationale: To provide easy access to supplies
Catheter • Place waste receptacle in an area near
you
• Open sterile pack using sterile technique.
Rationale: Sterile technique protects the
patient and prevents the spread of microorganisms
 Offer the pair of sterile gloves to the
doctor
• Place adequate amount of water
soluble lubricant over the non-
Straight dominant hand after the
Catheter doctor cleanses the urinary meatus

• Rationale: Lubrication facilitates

the insertion of the catheter and
reduces trauma to the tissues
 • Instruct the client to breath through
the mouth while doctor inserts
catheter to the urinary meatus
Straight • Rationale: The sphincter relaxes, and the
catheter can enter the bladder easily
Catheter when the client relaxes
• Collect a urine sample.
 • Remove the equipment and
position the client comfortable in
Straight bed. Clean and dry the perineal
area, if necessary.
Catheter • Send the urine specimen to the
laboratory promptly

Rationale: To prevent contamination

and spoiling of the specimen
 • Perform proper hand washing.

Straight • Record the time of the

catheterization, the amount of
Catheter urine removed, a description of
the urine, the patient’s reaction to
the procedure, and your name.
 • Follow the first 9 steps of straight
catheterization
• Open the Foley catheter and serve to
Indwelling the physician
Catheter • Place an adequate amount of water-
soluble lubricant over the non-
dominant hand after the
doctor cleanses the urinary meatus
 • Instruct client to breath through the
mouth while doctor inserts catheter to
the urinary meatus
• Inflate the balloon according to the
Indwelling manufacturer’s recommendation. Inject
Catheter the entire volume supplied in the pre-
filled syringe.

Rationale: The balloon anchors the catheter in

place in the bladder. Sterile water is used to
inflate the balloon as a precaution in case the
balloon ruptures
 • Attach end of catheter to drainage
system.
• Rationale: Closed drainage system
Indwelling minimizes the risk for organisms being
Catheter introduced into the bladder.
• Place drainage bag in a dependent
position
• Rationale: Dependent position of drainage
bag promotes flow of urine from the bladder.
 • Tape catheter

a. Female: Secure the catheter to the

upper thigh with a Velcro leg strap or
Indwelling hypoallergenic tape. Leave some slack in the
catheter to allow for leg movement
Catheter
b. Male: Secure the catheter on the
upper thigh or lower abdomen with the penis
directed toward the client’s chest. Slack should
be left in the catheter to prevent tension
 • Check that the drainage tubing is not
kinked and that movement of side
rails does not interfere with catheter
Indwelling or drainage bag.
Catheter • Remove the equipment and male the
client comfortable in bed. Clean and
dry the perineal area, if necessary.
 • Send the urine specimen to the
laboratory promptly
Indwelling
• Rationale: Urine kept at room
Catheter temperature may cause organisms, if
present, to grow and distort
laboratory findings

• Perform hand hygiene

 • Record the time of the
catheterization, the amount of
Indwelling urine removed, a description of
the urine, the patient’s reaction to
Catheter the procedure.

• Rationale: A careful record is

important for planning the
patient’s care.
Thank you!

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