CATHETERIZATION

CATHETERIZATION

Urinary catheterization is the introduction of a catheter through the urethra into the bladder for the purpose of withdrawing urine.

TYPES
Intermittent - Periodic catheterization to facilitate urine flow.
Indwelling - A thin tube communicating to the body surface, inserted into the vascular system and positioned to permit pressure measurements or blood sampling over a long period of time.

PURPOSES
  1. to relieve urinary retention.
  2. To obtain a sterile urine specimen from a woman.
  3. To measure the amount of residual urine in the bladder.
  4. To obtain a urine specimen when a specimen cannot be secured satisfactorily by other means.
  5. To empty the bladder before and during surgery and before certain diagnostic examinations.
EQUIPMENTS
* sterile gloves * antiseptic cleansing solution
* cotton balls * water-soluble lubricating jelly
* forceps * prefilled syringe
* drape
* indwelling catheter with drainage tubing and collecting bag
PROCEDURE ( Female intermittent catheterization)
  1. Assemble equipments. Be sure to wash your hands thoroughly.
  2. Have the patient lie on a firm mattress.
  3. Provide for good light.
  4. After providing for privacy, position the patient in a dorsal recumbent position, with the knees flexed and feet about 2 feet apart, and drape the patient.
  5. If the patient is soiled, wash the area around the meatus well with soap or detergent and water, then rinse and dry.
  6. After putting on sterile gloves, arrange the sterile equipment for convenience and to avoid contamination.
  7. Place the sterile drapes adjacent to the meatal area. Use the drape corners to wrap around the gloved hands.
  8. Lubricate the catheter fro about 3.7 cm being careful not to fill the eyes of the catheter.
  9. Place the thumb and one finger between the labia minora, and identify the meatus.
  10. Be prepaired to maintain separation of the labia with one hand until urine is flowing well and continously.
  11. Cleanse the exposed area at the meatus thoroughly using the solution of the agencys choice. Move the cotton ball held in a forceps fro above the meatus down toward the rectum.
  12. With the uncontaminated gloved hand, pick up the catheter and insert it into the meatus 5 cm to 7.5 cm.
  13. Do not use force to push the catheter through the urethra into the bladder.
  14. Ask the patient to breathe deeply, and rotate the catheter gently if slightly resistance is met as the catheter reaches the external sphincter.
  15. Hold the catheter surely while the bladder empties. Do not move the catheter in and out as the bladder drains.
  16. When the flow of urine begins to decrease, withdraw the catheter slowly, about 1 cm at a time, until urine barely drips, and then withdraw the catheter.
  17. Remove the equipment, and make the patient comfortable in bed. Send the urine specimen to the laboratory promptly or refrigerate it.
  18. Record the time of the catheterization, the amount of urine removed, a description of the urine, the patients reaction to the procedure, and your name.
FOR MALE ( indwelling )
The procedure for catheterizing the male patient is similar to the procedure described above. Only the differences are described below.
  1. Position the patient on his back. The procedure is usually easier when the patients legs are together. Drape the patient so that only the area around the penis is exposed.
  2. Place the catheter set on or next to the patients legs.
  3. Generously lubricate the catheter for about 15 cm to 18 cm, being careful not to plug the eyes in the catheter.
  4. Lift the penis with one hand, which is then considered contaminated. Cleanse the area at the meatus well with cotton balls held with a forceps in a circular motion.
  5. Pull the penis with gentle traction straight up with the fingers on the sides of the penis. Slightly pinch the end of the penis, and insert the catheter for 15 cm to 20 cm.
  6. Do not use force to introduce the catheter. If the catheter resists entry, ask the patient to deep breathly, and rotate the catheter slightly.
  7. Exert slight tension on the catheter after the balloon is inflated to assure its proper placement in the bladder.
  8. Connect the catheter to the drainage tubing and drainage bag if not already connected.
  9. Tape the catheter along the anterior aspect of the thigh.
  10. Hang the drainage bag on the frame of the bed below the level of the bladder.

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