Catheters

Kylie Kohler,
Lauren Makosky,
Tori McCormick,
Selina Nuzzi, &
Sydney Schisler
Indwelling Catheter
Foley Catheter

Suprapubic Catheter

Can be used for short or long term use

Foley catheters are inserted into the urethra and a tiny balloon is inflated at the end of
the catheter to keep it in place

Suprapubic catheters are inserted during surgery through the abdomen and into the
bladder

Indwelling catheters are often used short term after surgical procedures or long term for
conditions that affect the nerves of the bladder or people who are immobile or who
Indwelling Catheter
External Catheters
Often referred to as condom catheters for males but can also be used on females as a
pouch placed on the outside of the body

Most frequently used in people who have severe mental disabilities

These catheters can be used long term with a lower risk of infection and are typically
more comfortable for the patient to wear
Intermittent Catheter
Used for short term immediate drainage of the bladder

These catheters are inserted and then removed immediately after the bladder is empty

These are used for people with urinary incontinence, males with enlarged prostates,
people with neurological disorders, or conditions that don’t allow people to fully
enter the bladder

Patients often learn to do this to themselves and do it on a daily basis at home

Reasons Someone Would Need A Catheter
There are many reasons that one may need a catheter placed, some reasons may be:

Unable to control when one urinates

Continuous leakage of urine

Severe enlargement of prostate gland

Blood clots

Kidney or bladder stones

Injury to nerves of the bladder

Spinal cord injury

Male Catheterization
Before placing a catheter always make sure there is a medical order

Gather equipment and perform hand hygiene

Pull the curtain or close the door to give the patient privacy

Open the sterile catheterization tray on a clean surface, put on sterile gloves and open
the drape and place on the patient's thighs

Open all of the supplies and lift the penis with the nondominant hand, if the patient is
uncircumcised, pull back the foreskin

Use the dominant hand to pick up an antiseptic swab, using a circular motion clean the
penis, moving from the meatus down the glans of the penis, repeat this 2 more times
Male Catheterization
Using the dominant hand gently insert the tip of the prefilled syringe with lubricant into
the urethra and instill the 10mL of lubricant into the meatus

Advance the catheter to the bifurcation and do not use any force while inserting

At this point there should be a urine return and now inflate the balloon with the entire
volume of sterile water in the prefilled syringe

Once the balloon is inflated the catheter may be gently pulled back into place and if the
patient is uncircumcised, replace the foreskin

Remove equipment and discard according to facility policy, then place the drainage bag
below the level of the bladder
Maintaining A Sterile Field
A sterile field is a microorganism free are and to maintain an area free of these includes
wearing sterile gloves, gowns and drapes

To keep a sterile field anyone who is sterile can only come in contact with sterile areas

Tables are only sterile at tabletop level

Always face a sterile field, if you turn your back on a sterile field you cannot guarantee
that its sterile

The edges of sterile containers are not considered sterile once opened
Female Catheterization
Place the female patient in the supine position with the knees flexed and separated and feet
flat on the bed, about 60 cm apart. If this position is uncomfortable, instruct the patient
either to flex only one knee and keep the other leg flat on the bed, or to spread her legs as
far apart as possible. A lateral position may also be used for elderly or disabled patients.
With the thumb, middle and index fingers of the non-dominant hand, separate the labia majora
and labia minora. Pull slightly upward to locate the urinary meatus. Maintain this position
to avoid contamination during the procedure.
With your dominant hand, cleanse the urinary meatus, using forceps and chlorhexidine soaked
cotton balls. Use each cotton ball for a single downward stroke only.
Place the drainage basin containing the catheter between the patient’s thighs.
Female Catheterization
Pick up the catheter with your dominant hand.
Insert the lubricated tip of the catheter into the urinary meatus.
Advance the catheter about 5-5.75 cm, until urine begins to flow then advance the catheter a further 1-2 cm.
Note: If the catheter slips into the vagina, leave it there to assist as a landmark. With another lubricated sterile
catheter, insert into the urinary meatus until you get urine back. Remove the catheter left in the vagina at this
time.
Attach the syringe with the sterile water and inflate the balloon. It is recommended
to inflate the 5cc balloon with 7-10cc of sterile water, and to inflate the 30cc balloon
with 30-35cc of sterile water.
Improperly inflated balloons can cause drainage and leakage difficulties.
Gently pull back on the catheter until the balloon engages the bladder neck.
Complications and Treatments
Urinary Tract Infections

When To Call A Health Care Professional

Treatments of Urinary Tract Infections

Common Complications

Why They Happen and Quick Fixes

Urinary Tract Infections (UTI)
Number one associated risk factor

Cause is bacteria

Prevention is key
Symptoms of Urinary Tract Infections (UTI)
Fever Blood in the urine

Chills Lower back pain

Headache Achiness
Cloudy Urine

Burning

Catheter leakage

Foul smelling urine

When to Call a Doctor
Pain around sides and lower back

Urine abnormalities

Smell, Color, Cloudiness

Fever

Chills

Burning sensation in bladder area

Not feeling like yourself

Treatment of UTI’s
Antibiotics

Bactrim, Macrobid, Cipro, Levaquin, Keflex, Zithromax

Pain Medication

Pyridium

Anti-inflammatories
Complications and Some Quick Fixes
Allergic reaction to material used in catheter

Always be aware of Latex allergies

Leakage around catheter

Size Matters

Bladder Spasms

Medication: Bethanechol (urecholine)

Blockage

Change of catheter
Catheter Care
Preventing infection and complications

Hand washing
Catheter Tubing & Collection Bag
Urine should be flowing out of catheter into urine collection bag and tubing should not
be kinked or twisted

The bag should always be placed below the level of the bladder

The bag shouldn’t be dragging or pulling on catheter

Catheter bag should never be placed on the patient’s bed

A leg bag may be preferred for some patients

Cleaning a Catheter & Inspecting Catheter Site
The area around the catheter should be cleaned at least twice a day with soap and water
and dried with a clean towel afterwards

The patient may shower with the catheter in place at home unless contraindicated by the
physician

Powder and lotion should not be applied to the skin around the catheter to prevent
irritation and infection

When inspecting the catheter site, signs of infection should be assessed for

S/S of infection: swelling, redness, tenderness, irritation, or any pus/drainage around the
site of insertion
Emptying a Urine Collection Bag
Emptied when it becomes ½ to ⅔ full or every 3-6 hours

Hands need to be washed with soap and water and gloves should be worn if it’s a nurse
or another person emptying the patient’s bag

The drain spout is removed from the sleeve at the bottom of the bag and the valve on the
spout needs to be opened

Urine is drained out into a toilet or container and the tubing and drain spout shouldn’t
touch anything

Be sure valve is closed before putting it back into the sleeve on the bag or else urine will
spill out all over the floor
When to Call a Physician
No urine or minimal urine flowing into the bag for 4 hours or more

New pain in the abdominal or pelvic region occurs

Urine has changed color, appears cloudier, bloody, or has a foul odor

The site of insertion shows signs of infection as mentioned earlier, has urine leaking, or
there are signs of a kidney infection (fever of 100.4 or higher, flank pain)
Benefits of Catheters
A patient with urinary retention or incontinence benefit from a catheter because they
don’t have the ability to empty their bladder or are unable to control when they
urinate

Catheters get rid of the urgency to get to a toilet constantly

Patients with a urinary tract obstruction, such as a bladder stone or a swollen prostate
gland in men benefit from a catheter if the obstruction cannot be removed right away

Bed-bound patients due to an acute or chronic illness benefit from catheters because
they are too weak or incapable of getting to a toilet safely
References
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overview#2

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https://www.mskcc.org/cancer-care/patient-education/caring-your-urinary-foley-catheter

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References Continued
Ennis JD, Wierbicky J, Nesathurai S. Spinal cord injury (thoracic). In: Frontera, WR, Silver JK,

Feneley RC. An indwelling urinary catheter for the 21st century. BJUInternational. 2012

June;109(12):1746-9.www.ncbi.nlm.nih.gov/pubmed/220940

Kim M.D., S. (2015, October 5). Urinary Catheters. Retrieved November 19, 2016, from

http://www.healthline.com/health/urinary-catheters#Types3

Living with a Urinary Catheter. (2014). Retrieved November 16, 2016, from

http://www.healthtalk.org/peoples-experiences/long-term-conditions/living-urinary-

catheter/advantages-indwelling-catheter

Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 3rd ed.

Philadelphia, PA: Elsevier Saunders; 2015:chap 156.