Definition: Catheterization- involves
inserting a small tube/ catheter through
the urethra in to the bladder to allow
urine to drain.
Types of Catheterization
Urinary catheterization
Supra pubic catheterization
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Purpose
To empty the bladder in case of
retention of urine, occurring as a post
operative complication
In case of retention due to injury or
tumor of the spinal cord
In case of obstruction due to the
blockage of the urethra causing stricture
To obtain sterile specimen of urine
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To ensure that the bladder is empty
before an abdominal or pelvic operation
or Paracenthesis
To keep incontinent patient dry
To avoid contamination after operation
of vagina or perineum
To empty bladder irrigation or
instillation of the bladder
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To determine if residual urine is present
in the bladder
For an accurate measurement of urinary
out put
To facilitate healing of urethra
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Catheters: are tubes commonly made of
rubber or plastics, although certain types
are made of woven silk or metal.
Categories of urethral catheters
1. Straight or Robinson catheter a single
lumen tube
2. Retention or Foley catheter contains
second lumen ( two and three way
catheter)
3. Coude (elbowed):- used for elderly
men who have BPH- which is curved tip
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Catheterization using a straight
or plain catheter for female
Definition: introducing plain or straight
catheter through the female urethra to
the urinary bladder
Purpose
To relieve discomfort due to bladder
distention
To obtain a sterile urine specimen
To empty the bladder prior to surgery
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Equipment
Sterile
2 Sterile plain catheter rubber or plastic
A bowl for antiseptic
Gauze
Sterile towel(3)
forceps 3
Sterile receiver
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Kidney dish
Sterile urine specimen container if
needed
Clean
Rubber and draw sheet
Antiseptic solution
Receiver
Measuring jug
Flash light Screen
Specimen form
Screen
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1. Explain procedure to the patient
2. Screen the bed
3. Wash hands
4. Turn blanket and bedspread down to
foot of bed
5. Turn top linen up wards to the patient’s
chest to protect form complete
exposure.
6. Place patient in dorsal recumbent
position with the knees flexed and thigh
apart then
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[Link] rubber and draw sheet under
buttocks, cover patient with the linen(if
patient soaked use examination glove)
8. Apply disposable glove
9. Clean starting from mid thigh with
clean warm water and soap and dry the
area
10. Open sterile filed
11. Done sterile gloving
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12. Create a sterile field and Drape the
client with a sterile drape (bottom far
side nearside pubic area)
13. Prepare the equipment and Put
receiver for urine near the genital area
14. Place sterile equipment on drape
between patient tight
15. Prepare the equipment and Put
receiver for urine near the vulva.
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16. Use nondominant hand to separate
labia until the catheter is inserted
17. Wash the outer skin folds then inner
labia and urethral meatus with
antiseptic solution from front to back.
(Starting from outer proceeding to
inside)
18. Put forceps in the receiver kidney
dish
19. Wash and Rinse the area well from
outer skin folds then inner labia and
urethral meatus finally with distil water
from front to back.
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20. Put forceps in the receiver kidney dish
21. Dry the dry gauze the outer skin folds
then inner labia and urethral meatus
from front to back
22. Put forceps in the receiver kidney dish
23. Lubricate the insertion tip of the
catheter (5-7 cm in)
24. Expose the urinary meatus adequately
by retracting the tissue or the labia
minora in an upward direction
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25. Gently insert the catheter into
meatus until urine is noted. Continue
inserting for 2.5 to 5cm additional.
26. Remove catheter after desired
duration or all expected urine expelled
27. Measure urine, dry area with dry
gauze, remove bed protection
28. Position patient comfortable and
cover
29. Remove and clean equipment
30. Send specimen to the laboratory
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Definition: Introducing plain or straight
catheter through the male urethra to
the urinary bladder
Purpose
To relieve discomfort due to bladder
distention
To obtain a sterile urine specimen
To empty the bladder prior to surgery
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Equipment
Sterile
2 Sterile plain catheter rubber or plastic
A bowl for antiseptic
Cotton swab
Gauze
Large sterile fenestrated towel
Sterile towel
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forceps ( 3 )
Sterile receiver
Kidney dish
Lubricant
Sterile urine specimen container if
needed
Clean
Rubber and draw sheet
Antiseptic solution
Receiver
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Measuring jug
Flash light
Screen
Specimen forms
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1. Explain procedure to the patient
2. Screen the bed
3. Wash hands
4. Turn top linen up wards to the
patient’s Umbilicus and blanket and
bed spread up to mid-thigh.
5. Place patient in dorsal recumbent
position with the knees flexed and
thigh apart then put rubber and draw
sheet under buttocks, cover patient
with the linen
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6. Wash the perennial area with warm
water and soap
7. Wash hands
8. Open sterile field
9. Put on sterile gloves
10. Place sterile towel under the patient
and fenestrated towel over the patient
thigh
11. Prepare antiseptic swabs and Pick up
penis with non-dominate hand protract
foreskin if not circumcised, grasp directly
behind glans and spread meatus
between forefingers and thumbs.
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12. Cleanse penis using circular motion,
starting over meatus and working down
wards glans, repeat procedure twice
using new swabs always by the help of
forceps.
13. Pick up catheter, lubricated at least
7.5cm from distal end. Draw penis
upwards and forwards at 900 angle to
the leg insert the catheter, lower penis
when feeling resistance at an angle of
60 degree
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14. Insert catheter about 18-20cm till
urine flow
15. Remove catheter, replace foreskin to
avoid complication
16. Remove catheter measure urine, dry
area with dry cotton swab, remove bed
protection position patient comfortable
and cover
17. Remove and clean equipment
18. Send specimen to the laboratory
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Insertions of indwelling catheter for male
patient
Definition: introductions of indwelling catheter
through the male urethra in to the bladder
Purpose
To prevent retention by use of an
indwelling catheter
To prevent frequent catheterization in
case where pt is unable to pass urine
To prevent bed sore in case of urine
incontinence
To prevent infection in cases of perineal
operation
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Equipment
Indwelling catheter rubber or plastic
A bowl for antiseptic
Cotton swab
Gauze
Large sterile fenestrated towel
Sterile towel
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Forceps ( 3 )
Sterile receiver
Kidney dish
Syringe
Sterile water
Lubricant
Sterile urine specimen container if
needed
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Clean
Rubber and draw sheet
Antiseptic solution
Receiver
Urinary drainage bag
Screen
Adhesive plaster
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Procedure
1. Explain procedure to the patient
2. Screen the bed
3. Wash hands
4. Turn top linen up wards to the
patient’s chest to protect from
complete exposure.
5. Place patient in dorsal recumbent
position with the knees flexed and
thigh apart then put rubber and draw
sheet under buttocks, cover patient
with the linen
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6. Wash the perennial area with warm
water and soap
7. Wash hands
8. Prepare sterile trolley
9. Uncover patient,
10. Put on sterile gloves, place sterile
towel under the patient and
fenestrated towel over the pt thigh
11. Test balloon before insertion on
sterile filed with recommended
amount of sterile water
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12. Prepare antiseptic swabs and Pick
up penis with non-dominate hand
retract foreskin if not circumcised,
grasp directly behind glans and
spread meatus between forefingers
and thumbs.
13. Cleanse penis using circular
motion, starting over meatus and
working down wards glans, repeat
procedure twice using new swabs
always by the help of forceps.
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14. Pick up catheter, lubricated at least
7.5cm from distal end. Draw penis
upwards and forwards at 900 angle to the
leg insert the catheter, lower penis when
feeling resistance at an angle of 60
degree
15. When catheter is inserted, inflate
the balloon with 5-15ml as indicated
on catheter
16. Pull gently on the end of the
catheter to be sure it will not leave the
bladder then push back 2cm to relieve
pressure from sphincter
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17. Attach drainage tube to catheter and
drainage bag
18. Tie tube and drainage bag to the
bed ,put the bottle below the patient
level
19. Cover and comfort the patient
20. Return the equipment
21. Wash hands and document the
procedure
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Definition: Introduction of the indwelling
catheter through the female urethra in the
bladder
Purpose
To prevent retention by use of an
indwelling catheter
To prevent frequent catheterization in
case where pt is unable to pass urine
To prevent bed sore in case of urine
incontinence
To prevent infection in cases of perineal
operation
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Equipment
Sterile
Indwelling catheter rubber or plastic
A bowl for antiseptic
Cotton swab
Gauze
Large sterile fenestrated towel
Sterile towel
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Forceps ( 3)
Sterile receiver
Kidney dish
Syringe
Sterile water
Lubricant
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Clean
Rubber and draw sheet
Antiseptic solution
Receiver
Urinary drainage bag
Screen
Adhesive plaster
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1. Explain procedure to client and Provide
for privacy
2. Set the bed to a comfortable height to
work, and raise the side rail on the side
opposite you.
3. Assist the client to a supine position with
legs spread and feet together or to a
side-lying position with upper leg flexed.
4. Drape client’s abdomen and thighs.
5. Ensure adequate lighting of the
perineum
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6. Wash hands, don disposable gloves,
and wash perineal area from the mid
thigh.
7. Remove gloves and wash hands.
8. bring urine collection bag ready for
attaching near to side of bed
9. Done sterile gloving
10. Create a sterile field and Drape the
client with a sterile drape (bottom far
side nearside pubic area)
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11. Prepare the equipment and Put
receiver for urine near the genital area
12. Place sterile equipment on drape
between patient tight
13. Prepare the equipment and Put
receiver for urine near the vulva.
14. Use nondominant hand to separate
labia until the catheter is inserted
15. Wash the outer skin folds then inner
labia and urethral meatus with
antiseptic solution from front to back.
(Starting from outer proceeding to
inside)
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16. Put forceps in the receiver kidney dish
17. Wash and Rinse the area well from
outer skin folds then inner labia and
urethral meatus finally with distil water
from front to back.
18. Put forceps in the receiver kidney dish
19. Dry the dry gauze the outer skin folds
then inner labia and urethral meatus
from front to back
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20. Put forceps in the receiver kidney dish
21. Lubricate the insertion tip of the
catheter (5-7 cm in)
22. Expose the urinary meatus
adequately by retracting the tissue or
the labia minora in an upward direction
23. Gently insert the catheter into meatus
until urine is noted. Continue inserting
for 2.5 to 5cm additional.
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24. After catheter insertion, the balloon is
inflated to hold the catheter in place
within the bladder.
25. Instruct the client to immediately
report discomfort or pressure during
balloon inflation; if pain occurs,
discontinue the procedure, deflate the
balloon, and insert the catheter further
into the bladder.
26. Gently pull the catheter until the
retention balloon is snuggled against
the bladder neck (resistance will be
met) re-push back 2cm after the test
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27. If laboratory test is prescribed,
collect some amount of urine in the
sterile specimen bottle straight from
the catheter
28. Secure the catheter to the abdomen or
thigh and connect to drainage tube
29. Place the drainage bag below the level of
the bladder.
30. Remove gloves, dispose of
equipment, and wash hands.
31. Help client adjust position.
32. Assess and document
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Definition- The condom catheter is an
external drainage system to collect
urine from male clients who have
incontinence
Purpose
Provide a means of collecting urine and
controlling incontinence without the risk
of infection that an indwelling urinary
catheter imposes
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Equipment
Condom catheter kit with adhesive strip
Urinary drainage bag/bed pan
Clean gloves
Basin with warm water and soap
Towel and washcloth
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1. Wash hands and apply gloves.
2. Select an appropriate condom catheter.
3. Cleanse the penile shaft.
4. Inspect the penile shaft for excessive
hair.
5. Inspect the penis for altered skin
integrity.
6. Stretch the shaft of the penis and unroll
the condom to the base of the penis.
7. Follow product directions for the
application of the sealant
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8. Attach the condom to the drainage
apparatus,
9. either a leg bag or bedside drainage
bag.
10. Remove gloves and wash hands.
11. Remove and reapply the condom
catheter every 24 to 48 hours, or when
leakage occurs
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Definition: Suprapubic catheter is
inserted through the abdominal wall
above the symphysis pubis into the
urinary bladder.
Purpose
To prevent bladder infection
To keep skin integrity
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Care of clients with Suprapubic
catheter include
Regular assessment of the client’s urine,
fluid drainage system.
Skin care around the insertion site
involves sterile technique.
Periodic clamping of the catheter
preparatory to removing it and
measurement of residual urine.
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Leaving the catheter open to drainage
for 48 to 72 hours then clamping the
catheter for 3 to 4 hour periods during
the day the client can void satisfactory
amounts.
Dressing should be changed whenever
they are soiled.
A small amount of iodine is used.
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