Urinary Catheterization

• Catheterization may not be performed without a doctor’s order.
• It is considered an invasive procedure
• Why?
• Strict sterile technique must be maintained!

Indications
• Decompression of the bladder
• To provide better visualization during abdominal procedures
• To prevent trauma during abdominal procedures
• To promote healing following GU procedures
• Drainage of urine
• To prevent the overfilling of the bladder during lengthy procedures
• To measure urinary output
• To obtain a sterile specimen
• To relieve urinary retention
• To treat urinary incontinence
• Irrigation of the bladder
• Control of bleeding
• The balloon can be placed in the bladder neck following TURP to tampenade excised area

Considerations
• In surgical cases the catheter will be following induction of anesthesia
• Insertion of catheter may cause an infection and/or injury to the urethra & bladder
• Use the smallest size to drain the urine without leakage around the edges
• The Foley catheter is the most common style
• The balloon should be filled with water
• Saline breaks down the catheter material
• Air could cause an embolism
• 10cc of water is used to completely fill a 5cc balloon
• To compensate for the water that remains in the infiltration channel
• Urine is drained by gravity
• The catheter is attached to a urinary drainage bag
• It should be placed below the level of the bladder
• The catheter should be secured to the pts thigh to prevent tension and accidental removal
• Always check the patient post op to find out if they have a catheter
• If you move a pt with a catheter and you forget to check, it can be pulled out when you transfer them to the stretcher
Types of Catheters
• Red Rubber (straight) catheter
• For in and out application
• Not for continuous drainage

A. Conical-tip urethral catheters
B. Coudé hollow olive-tip catheter
E. Malecot self-retaining urethral catheter
F. Foley-type balloon catheter
G. Foley-type, three-way balloon catheter

Sizes of Catheters
• Range from 8 fr to 30 fr
• Use 8 fr to 12 fr for pediatrics
• 14 fr to 30 fr for adults
• The most common size used for adults is 16 fr
Procedure for Females
• Pt is placed in the frog-leg position
• If not already in lithotomy
• The catheter kit is placed between the legs and opened
• Apply gloves using the open technique
• Create the sterile field and place the fenestrated drape with the opening over the vulva
• Check the catheters balloon to make sure there are no leaks in the balloon and the valve works correctly
• Place the lubricate on the end of the catheter
• Open and pour the prep solution in to the tray provided
• With non dominant hand separate the labia majora and locate the urethral meatus
• If you remove your hand at any time during the procedure you will have to start over
• Using the disposable forceps with dominant hand pick up a cotton ball and dip into prep solution
• You will need three cotton balls for the whole procedure
• With the first cotton ball, cleanse laterally from clitoris to vaginal opening
• Discard cotton ball
• With the second cotton ball, cleanse the other side
• Discard cotton ball
• With the third cotton ball, cleanse directly down the middle
• Discard cotton ball
• Insert the catheter into the urethral opening approximately half the length of the catheter
• If you miss the urethra and it accidentally inserts into the vagina, another catheter must be used
• Wait until urine flows before you inflate the balloon
• Pull the catheter just until you feel resistance
• Secure the catheter to the pts leg