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Urinary Catheterization

Check order
Consider why patient is being catheterized
Provide perineal care (especially for female patients); note if additional lighting and/or help will be needed for catheter insertion

Gather needed equipment (and help if required); if you need something other than medium sterile gloves, get the correct size of gloves (most catheterization kits come with size 7 - 7 1/2 gloves)

Contents:
-Waterproof Absorbent Underpad
-Pair Latex-Free gloves
-Fenestrated Drape
-1 Package Povidone-Iodine Solution
-5 Cotton Balls
-1 Package Water-Soluble Lubricant
-1 Prefilled 10 ml Syringe of Sterile Water

Minicath for collection of sterile urine specimen from female patients

Coude catheter

14 G Coude tipped catheter

14 G Malecot tipped catheter

14 G Mushroom tipped catheter

Catheter for continuous bladder irrigation

3-way catheter for irrigation

Set up equipment


Position patient: -female patient: lithotomy position (can also use sidelying position) - male patient: supine with thighs together. Remove sterile drape from catheterization kit. Lift the drape away from the kit to prevent contamination.
For the female patient:	For the male patient
	To review donning sterile gloves
The fenestrated drape is frequently not used for female patients since it may obscure your view.	Now finish preparing the equipment. You may want to do this before placing drape if patient cannot hold still for long.
You may want to save one cotton ball to remove excess povidone-iodine from urinary meatus to improve visualization. Move one of the cotton balls to elsewhere on the tray before pouring the solution.	For the female patient, you will lubricate the end of the catheter. For a male patient, you can insert the lubricant directly into the end of the penis. Check facility policy to see if lidocaine jelly can be used for a lubricant with male patients.


Place top tray back onto box.	Move entire box to patient. Female patient: place box next to sterile field between patient's legs. Male patient: place box on overbed table over patient's thighs.

Insert catheter

Once you have separated the labia with your nondominant hand, you must keep correct hand placement until after the catheter is inserted. Critical point: correct visualization of the urethral orifice
Cleanse each side and down the middle, going from top to bottom (clean to dirty). If you saved one cotton ball without povidone-iodine, you can wipe down the middle to improve visualization.

	Once the balloon is inflated, you can let go of the catheter remove the syringe (while maintaining pressure) put drainage bag on the side of the bed, drape catheter tubing on the bed (no dependent loops) Attach catheter to patient's thigh according to agency policy, leaving enough slack to prevent pulling on catheter with patient movement Document procedure, including appearance and volume of urine and patient tolerance of procedure

For the male patient

Cleanse the meatus using a circular motion cleansing around the meatus, then around the tip of the penis (use a new cotton ball for each circle)
When inserting a catheter in the male patient, hold the penis upright to straighten the urethra.
Insert catheter approximately 8 inches until urine is obtained. Advance catheter another 1-2 inches before inflating balloon (to be sure that balloon is in bladder before inflation)
	A catheter specifically for male catheterization may need to be used. Prostatic hypertrophy is a common cause of difficulty in passing a catheter in a male patient. If resistance is felt, lower the penis to a 45⁰ angle.
If a catheter is taped into position, the recommendation is to tape it to the patient's abdomen to prevent pressure being placed on the urethra

Videos:


	3-Way Bladder Irrigation (Nesbitt Young Irrigation) (6 minutes, 0 seconds) Bladder Irrigation (Nesbitt Young Irrigation) - Demonstration of CBI (Continuous Bladder Irrigation) is a continuous infusion of sterile solution into the bladder, most often, using a threeway irrigation closed system with a triple-lumen catheter. Infrequently used following genitourinary surgery to keep the bladder clear & free of blood clots or sediment. One lumen goes to the client to drain urine, one goes to the irrigation solution & one is used to inflate the catheter. Jamie Last, RN (SMMC)

	Peri Care (2 minutes, 07 seconds) PeriCare: Daily PeriCare and equipment used.¬ Angie Maloney, RN Charge Nurse Med Surg Unit Saddleback Memorial Medical Center, San Clemente Campus.

	Foley Care (2 minutes, 35 seconds) Foley Care: Demonstration; Care of Foley-Indwelling Catheter and Use of Stat Lock. Angie Maloney, RN Charge Nurse Med Surg Unit Saddleback Memorial Medical Center, San Clemente Campus.

	Foley Catheter Insertion (6 minutes, 0 seconds) Foley Catheter Insertion: Demonstration in the skills lab. Jennifer Forouzesh, RN,BSN,MSN (faculty)

	Foley Catheter Tubing and Collection Bag (2 minutes, 0 seconds) Foley Catheter Tubing: Catheter securement device, collection bag with urometer. Barbara, RN (SMMC)

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