Inserting a straight or indwelling catheter

Catheterization – is the introduction of a catheter through the urethra to the bladder for
the purpose of withdrawing urine.

Its purposes is:

1. To prevent and relieve over distention of bladder.
2. To empty the bladder when condition contraindicated urination in the normal
way.
3. To obtain urine specimen.
4. To assess the amount of residual urine if the bladder empties incompletely.
5. To provide for continuous bladder drainage and irrigation.
6. To manage incontinence when other measures have failed.

Equipment:
• screen – for draping
• blanket
• flushing tray – for perineal care
• bed pad
• rubber sheet
• disposable gloves
• catheterization tray with the following: catheter, sterile gloves, flash light,
antiseptic cleaning solution, forceps, syringe w/ sterile water, k.y. jelly,
kidney basin, specimen bottle, cotton balls, micropore, receptacle or basin.

Procedure:
• Greet and identify the patient. Explain the procedure.
• Wash hands.
• Gather all equipments.
• Close curtain or door.
• Adjust the bed. – for proper body mechanics.
• Raise bed rails.
• Place the rubber sheet under client.
• Position the client. For female dorsal recumbent and for male supine position
with thighs slightly abducted. – for better visualization
• Drape client
• Wear disposable gloves – for perineal washing then dry and discard gloves.
• Provide adequate lightning
• Wear sterile gloves.
• Check integrity of the indwelling catheter. Ask someone to assist you in opening
the cover. Inject fluid into balloon port then detach the water.
• Cleanse the urethral meatus. Female: with non-dominant hand, spread labia
minora to expose urethral meatus. with dominant hand clean the perineal area
from least to most contaminated with antiseptic solution, using downward stroke
and each stroke use one cotton ball and discard. Male: Grasp the penis at shaft
 with non dominant hand and retract the urethral meatus with the index and fore
finger. with dominant hand clean penis in circular motion from meatus to base of
penis. using clean cotton balls each time.
• Lubricate catheter. Female1-2 inches and for male 5-7 inches. – ease insertion of
catheter through urethral canal.
• Insert catheter. Female: Ask client to bear down gently to relax the external
sphincter and slowly insert catheter 2-3 inches until urine flows out from catheter
and advance another 1-2 inches to ensure bladder placement. Release labia and
hold catheter securely. Male: Lift penis and apply light traction. Ask client to
bear down, insert 7-9 inches. If resistance felt do not force wait for a few seconds
or rotate gently. And advance 1-2 inches when the urine flows. Lower the penis
and hold catheter.
• Place end of catheter at urine receptacle.
• Collect urine specimen as needed.
• Inflate balloon, then release and pull gently to feel retraction.
• If the client feels pain deflate the balloon and insert catheter further into bladder.
• Attach collecting tube to drainage system.
• Tape the catheter to abdomen or thigh just enough not to pull on the bladder to
prevent tissue damage and reduces pressure on urethra.
• remove gloves
• Assist client in comfortable position.
• Do after care and wash hands.