Urinary_cathterization

PREPARED BY: RESHU ARORA
CLINICAL EDUCATOR
DEFINITION
Catheterization of the urinary bladder is the insertion of

a hollow tube through the urethra into the bladder for
removing urine. It is an aseptic procedure for which
sterile equipment is required.
PURPOSES
• Relieve urinary retention.

• Obtain a sterile urine specimen from a female patient.
• Measure residual urine.
• Empty the bladder before, doing or after surgery.
• Allow accurate measurement of urine output.
URINARY CATHETER SIZES
• The French scale (Fr.) is used to denote the size of
catheter. Each unit is roughly equivalent to 0.33mm in
diameter (i.e., 18Fr. Indicates a diameter of 6mm). The
smaller the number, the smaller the catheter. A large
sized catheter is used for a male because it is stiffer,
thus easier to push the distance of the male urethra.
Catheters come in several sizes:
• 8Fr & 10 Fr are used for children.
• 14Fr & 16Fr are used for female adults
• 20Fr & 22 Fr are usually used for male adults.
TYPES OF URINARY CATHETERS
• INTERMITTENT CATHETER: An intermittent
catheter is used to drain the bladder for short
period(5-10min). It may be inserted by the patients.
• RETENTION/INDWELLING CATHETER: This
type of catheter is placed into the bladder & secured
there for a period of time.
• SUPRA PUBIC CATHETER: This type of catheter
is inserted into the bladder through a small incision
above the pubic area. It is used for continuous
drainage.
 Condom catheter
 Silicon catheter
PREPARING FOR CATHETERIZATION
• A catheter should be used only when absolutely

necessary & the catheterization procedure itself
should be done only by trained personnel under
sterile conditions. Infection is a major risk of urinary
catheterization.
• Explain the procedure to the patient.
• Provide for privacy & adequate lighting.
• Positioning
 Position the female patient in an dorsal recumbent
position with the knees flexed & the feet about two
feet apart. Cover the upper body & each leg. Place the
catheter set between the female patient’s leg.
 Position a male patient in a supine position. Drape the
patient so that only the area around the penis is
exposed. Place the catheter set next to the legs of the
male patient.
ARTICLES
• Catheter
• 10cc syringe
• Sterile water
• Cotton balls with betadine
• Lubricant
• Sterile gloves
• Flashlight or lamp
• Urine collection bag
• Micropore
• Kidney tray & paper bag
INSERTNG THE FOLEYS CATHETER
IN A MALE PATIENT
a. Cleanse the genital & perineal areas with warm soap &
water. Rinse & dry.
b. Wash your hands carefully.
c. Open the sterile catheterization, kit using sterile
technique.
d. Put on the sterile gloves.
e. Open the sterile drape & place on the patient’s thighs.
Place fenestrated drape with opening on the penis.
f. Apply sterile lubricant liberally to the catheter tip.
Lubricate at least six inches of the catheter. Leave the
lubricated catheter on the sterile field.
g. Pour the antiseptic solution over the cotton balls.
h. Place the urine specimen collection container within
easy reach.
i. Grasp the patient’s penis between your thumb &
forefinger of your non-dominant hand. Retract the
foreskin of an uncircumcised male. The gloved hand
that has touched the patient is now contaminated.
j. Use the forceps to hold the cotton balls. This will
maintain the sterility of one hand. Using the forceps,
pick up one cotton ball & swab the centre of the
meatus outward in a circular manner.
k. Continue outward, using a new cotton ball for each
progressively larger circle. Clean the entire glands.
Deposit each cotton ball in the disposal bag. After the
last cotton ball is used, drop the forceps into the
disposal bag as well.
l. Hold the penis at a 90 degree angle. Advance
the catheter into the patient’s urinary meatus.
You may encounter resistance at the prostatic
sphincter.
1. Pause & allow the sphincter to relax.
2. Lower the penis & continue to advance the
catheter.
Note: never force the catheter to advance.
Discontinue the procedure if the catheter will
not advance or the patient has unusual
discomfort. Get assistance from the charge
nurse or physician.
m. When the catheter has passed through the prostatic
sphincter into the bladder, urine will start to flow.
Gently insert until 1to2 inches beyond where urine is
noted.
n. Inflate balloon, using correct amount of sterile liquid
(usually 10cc but check actual balloon size).
o. Gently pull the catheter until inflation balloon is snug
against bladder neck.
p. Connect catheter to drainage system.
q. Anchor the catheter tubing to the lateral abdomen
with tape, without tension or tubing.
r. Place drainage bag below level of bladder.
s. Evaluate catheter function & amount, color, odor,&
quality of urine.
t. Remove gloves, dispose of equipment appropriately,
wash hands.
u. Document size of catheter inserted, amount of water
in balloon, patient’s response to procedure, &
assessment of urine.
INSERTING THE FOLEYS CATHETER IN
A FEMALE CLIENT
• Follow the procedure same with male from step a-h.
• Place the thumb & forefinger of your non-dominant
hand between the labia minora, spread & separate
upward. The gloved hand that has touched the patient
is now contaminated.
• using the forceps, pick up a cotton ball saturated with
antiseptic solution. Use one cotton ball for each
stroke. Swab from above the meatus downward
towards the rectum.
• Keeping the labia separated, cleanse each side of the
meatus in the same downward manner. Do not go
back over any previously cleansed area.
• Deposit each cotton ball into the disposal bag. After
the last cotton ball is used, deposit the forceps into
the bag as well.
• Continue to hold the labium apart after cleansing.
Insert the lubricated catheter into the female patient’s
urinary meatus.
• Angle the catheter upward as it is advanced. If the
catheter will not advance, instruct the patient to
inhale or exhale slowly. This may relax the sphincter
muscle. Do not force the catheter.
• When urine starts to flow, insert the catheter
approximately one inch further. Place the cup under
the stream of flowing urine to obtain a sterile
specimen if required.
• Inflate balloon, using correct amount of sterile liquid
(usually 10ml but check actual balloon size).
• Gently pull catheter until inflation balloon is snug against bladder
neck.
• Connect catheter to drainage system.
• Connect the drainage bag to the catheter. Secure the catheter to the
inner aspect of the female patient’s thigh.
• Place drainage bag before below level of bladder.
• Evaluate catheter function & amount, color, odor, & quality of urine.
• Remove gloves & wash hands.
• Documentation.
THANK YOU

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PREPARED BY: RESHU ARORA

Catheterization of the urinary bladder is the insertion of

• Relieve urinary retention.

• A catheter should be used only when absolutely

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