Catheterization
Prepared By:
Christine L. Urbano
BSN917
Catheter
In medicine,a catheter is a tube that
can be inserted into a body cavity,
duct or vessel. Catheters thereby
allow drainage or injection of fluids or
access by surgical instruments.
In most uses a catheter is a thin,
flexible tube: a "soft" catheter; in
some uses, it is a larger, solid tube: a
"hard" catheter.
The ancient Greeks created catheters
from reeds. "Katheter" originally
referred to an instrument that was
inserted such as a plug.
word "katheter" in turn came from
"kathiemai" meaning "to sound" with a
probe.
The ancient Greeks inserted a hollow
metal tube through the urethra into
the bladder to empty it and the tube
came to be known as a "katheter."
Uses of a Catheter
-draining urine from the urinary bladder
as in urinary catheterization, e.g., the
Foley catheter or even when the
urethra is damaged as in suprapubic
catheterisation.
-drainage of fluid collections, e.g. an
abdominal abscess
administration of intravenous fluids,
medication or parenteral nutrition
-direct measurement of blood pressure
in an artery or vein
-direct measurement of
intracranial pressure
-administration of anaesthetic
medication into the epidural space,
the subarachnoid space or around a
major nerve bundle such as the
brachial plexus
-subcutaneous administration of
insulin or other medications, with the
use of an infusion set and
insulin pump
Kinds of Catheter
A central venous catheter is a conduit
for giving drugs or fluids into a large-
bore catheter positioned either in a
vein near the heart or just inside the
atrium.
A Swan-Ganz catheter is a special
type of catheter placed into the
pulmonary artery for measuring
pressures in the heart.
Condom Catheter
(Slang term: Texas Condom) is not a true
catheter, as it is not inserted into a body
cavity duct or vessel
this is a condom-like device with a plug
where the condom's reservoir tip would be,
and an adhesive at the base. This device
allows for urinary catheterization without
the insertion of a true catheter, and forms
part of a Stadium buddy.
Inserting a Straight or Indwelling
Catheter
Assessment
1. Assess status of client
a. When client last voided
b. Level of awareness or
developmental stage
c. Mobility and physical limitations of
client
d. Client’s sex and age
e. Distended bladder
f. Any pathologic condition that may
impair passage of catheter
g. Allergies
2. Review client’s medical record,
including physician’s order.
Planning
Develop individualized goals for
client based on nsg diagnoses
Promote patent urinary
drainage system
Maintain skin integrity
Maintain physical comfort
Prepare necessary equipments and
supplies
Sterile gloves (extra pair optional)
Sterile drapes
Lubricant
Cotton balls
Forceps
Pre-filled syringe w/ NSS to inflate balloon of
indwelling catheter
Catheter of correct size and type for procedure
Flashlight or gooseneck lamp
Bath blanket
Water proof absorbent pad
Trash receptacle
Disposable gloves, basin with warm
water, soap, face cloth, towel
Implementation
1. Wash hands
2. Raise bed to appropriate working height
3. Raise side rails and close cubicle or room
curtains
4. Place a waterproof pad and position the
client
Female-dorsal recumbent or in Sims’
Male- supine position with thighs slightly
abducted
5. Drape the client
Female- bath blanket in diamond
fashion
Male-bath blanket on upper trunk
and cover lower extremities with bed
sheets exposing only the genitalia
6. Using disposable gloves, wash
perineal area with soap and water
prn
[Link] inserting indwelling catheter, open
package containing drainage
system. Place drainage bag over
edge of bottom bed frame. Bring
drainage tube up between side rail
and mattress.
[Link] catheterization kit according to
instructions
9. Don on disposable gloves
10. Organize supplies on sterile field.
11. Apply sterile drape
12. Place sterile tray and contents on sterile
drape between thighs.
13. Determine that catheter tip is lubricated.
Female-2.5-5cm (1-2 in)
Male- 12.5-17.5 (5-7 in)
14. Cleanse urethral opening
Female- c non dominant hand carefully
retract labia to expose urethral opening.
-c dominant hand pick up cotton balls and
clean perineal area, front to back, from
clitoris down to anus
Male-retract foreskin c non dominant hand,
grasp penis at shaft just below glans
-c dominant hand pick up cotton balls c
forceps and clean penis, circular motion
from meatus down to base glans
15. Pick up catheter and insert.
Female- ask the client to bear down gently as
if to void and slowly insert catheter through
meatus.
-advance catheter aprox 5-7.5cm in adult,
2.5 in child or until urine flows. When urine
flows, advance another 5 cm.
-release labia and hold catheter securely with
non dominant hand.
Male- lift penis to position perpendicular to
client’s body
-ask client to bear down as if to void and
slowly insert catheter through meatus.
-advance catheter 17.5-22.5cm in adult
and 5-7.5cm in young child or until urine
flows. When urine flows, advance another
5 cm.
-lower penis and hold catheter securely
16. Collect urine specimen as needed.
17. Allow bladder to empty fully unless
institution policy restricts max vol of
urine to drain
18. Remove straight single use catheter
-withdraw slowly but smoothly until
removed.
19. Inflate balloon of indwelling catheter
While holding catheter with thumb and little
finger of non dominant hand at meatus, take
end of catheter and place it bet first two fingers
of non dominant hand.
With free dominant hand, attach syringe to
injection port at end of catheter
Slowly inject total amount of soln; if client
complains of sudden pain, aspirate back and
advance catheter further.
After inflating balloon fully, release catheter
and pull gently to feel resistance.
20. Attach end of catheter to collecting
tube of drainage system. Drainage
bag must be below level of bladder.
21. Tape catheter
Female- tape tubing to inner thigh with
strip or non allergenic tape. Allow for
slack movt
Male- tape tubing to top of thigh or
lower abdomen. Allow for slcak movt
Anchoring
22. Be sure that there are no obstruction or
kinks in the tubing.
23. Remove gloves and dispose of
equipments, drapes
24. Assist the client to comfortable position.
25. Instruct on ways to lie in bed with
catheter
26. Caution client against pulling on catheter
27. Wash hands.