Urinary Catheterization
Visual Guidance
To the left is a video clip that shows how to complete a straight catheter procedure on a female client.
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Above is a skill checklist for urinary catheterization that goes through the procedure step-by-step.
Assessment
A. Ask when the client last voided and the amount.
B. Check for bladder distention.
C. Assess the client's fluid intake and output.
D. Check for signs and symptoms of a urinary tract infection.
E. Determine the most appropriate method of catheterization based on the amount of urine needed.
F. Determine if the client has any allergies to antiseptic, tape, latex, or Betadine.
B. Check for bladder distention.
C. Assess the client's fluid intake and output.
D. Check for signs and symptoms of a urinary tract infection.
E. Determine the most appropriate method of catheterization based on the amount of urine needed.
F. Determine if the client has any allergies to antiseptic, tape, latex, or Betadine.
Equipment
A. Sterile catheter that is the right length and size. Bring an extra catheter just in case.
1. Right length: adult female 22 cm; adult male 40 cm
2. Right size: 8/10 Fr for children; 14/16 Fr for adults; 18 Fr for men (men need a larger size than women)
3. If using an indwelling catheter make sure to have the right balloon size: 10 mL for adults; 3 mL for children
B. Catheter kit
C. If a catheter kit is not available, then gather individual supplies.
1. 1-2 pairs of sterile gloves, water proof drapes, antiseptic solution, cleaning balls, forceps, water soluble lube, urine
receptacles, specimen container, and disposable clean gloves.
2. If using an indwelling catheter make sure to also include: a syringe prefilled with sterile water, collection bag, and
tubing.
1. Right length: adult female 22 cm; adult male 40 cm
2. Right size: 8/10 Fr for children; 14/16 Fr for adults; 18 Fr for men (men need a larger size than women)
3. If using an indwelling catheter make sure to have the right balloon size: 10 mL for adults; 3 mL for children
B. Catheter kit
C. If a catheter kit is not available, then gather individual supplies.
1. 1-2 pairs of sterile gloves, water proof drapes, antiseptic solution, cleaning balls, forceps, water soluble lube, urine
receptacles, specimen container, and disposable clean gloves.
2. If using an indwelling catheter make sure to also include: a syringe prefilled with sterile water, collection bag, and
tubing.
Key Points
A. Wash and dry hands before the procedure.
B. Check the physician's order.
C. Introduce self to the client, check the client's ID band, and explain the procedure.
D. Provide privacy.
E. Strict aseptic technique must be used at all times.
F. For a female client, position the client on back with knees flexed. For a male client position on back.
G. Have client breathe deeply upon insertion.
H. When inserting a catheter in a female: if there is no urine flow and the catheter is in the vagina, keep the catheter there as
a landmark for the next attempt with a new sterile catheter.
I. When inserting an indwelling catheter always test the balloon first before inserting it.
1. Insert the catheter 2-3 inches or until urine flows. Then advance another 1-2 inches.
2. Inflate the balloon once inserted. Make sure the balloon is not in the urethra. The client should have no discomfort as
the balloon is inflated.
3. Once the catheter is inserted and the balloon is inflated, pull gently to feel for resistance.
4. If a specimen is needed, obtain before attaching the urine drainage bag. If the catheter is part of a closed urinary system,
obtain a urine sample with a sterile needle and syringe.
B. Check the physician's order.
C. Introduce self to the client, check the client's ID band, and explain the procedure.
D. Provide privacy.
E. Strict aseptic technique must be used at all times.
F. For a female client, position the client on back with knees flexed. For a male client position on back.
G. Have client breathe deeply upon insertion.
H. When inserting a catheter in a female: if there is no urine flow and the catheter is in the vagina, keep the catheter there as
a landmark for the next attempt with a new sterile catheter.
I. When inserting an indwelling catheter always test the balloon first before inserting it.
1. Insert the catheter 2-3 inches or until urine flows. Then advance another 1-2 inches.
2. Inflate the balloon once inserted. Make sure the balloon is not in the urethra. The client should have no discomfort as
the balloon is inflated.
3. Once the catheter is inserted and the balloon is inflated, pull gently to feel for resistance.
4. If a specimen is needed, obtain before attaching the urine drainage bag. If the catheter is part of a closed urinary system,
obtain a urine sample with a sterile needle and syringe.
Post Procedure Assessment
A. Assess how the client tolerated the procedure.
B. Assess the urethral meatus and surrounding tissue for inflammation, swelling, and discharge. Ask the client if they are
experiencing any burning sensation or discomfort.
C. Clients with an indwelling catheter need to be assessed for any obstructions or kinks in the tubing. Make sure tubing is not
clogged with mucous or blood.
1. Make sure the catheter is securely attached to thigh or abdomen and that the tubing is fastened appropriately to
bedclothes.
2. Make sure that gravity drainage is maintained. There should be no loops in the tubing and the drainage receptacle needs
to be below the level of the client's bladder.
3. Drainage system needs to be sealed or closed. There should be no leaks at the connection sites in open systems.
4. Observe the flow of urine every 2-3 hours. Note the color, odor, and any abnormal constituents. If sediments are
present, check the catheter more frequently to see if it is clogged.
B. Assess the urethral meatus and surrounding tissue for inflammation, swelling, and discharge. Ask the client if they are
experiencing any burning sensation or discomfort.
C. Clients with an indwelling catheter need to be assessed for any obstructions or kinks in the tubing. Make sure tubing is not
clogged with mucous or blood.
1. Make sure the catheter is securely attached to thigh or abdomen and that the tubing is fastened appropriately to
bedclothes.
2. Make sure that gravity drainage is maintained. There should be no loops in the tubing and the drainage receptacle needs
to be below the level of the client's bladder.
3. Drainage system needs to be sealed or closed. There should be no leaks at the connection sites in open systems.
4. Observe the flow of urine every 2-3 hours. Note the color, odor, and any abnormal constituents. If sediments are
present, check the catheter more frequently to see if it is clogged.
Documentation
A. Date and time.
B. The last time the client voided and the amount.
C. If the client had any bladder distention.
D. What the nurse did (catheterization procedure)
E. Size of the catheter used.
F. If an indwelling catheter is used, document how much fluid is in the balloon.
G. How much urine was collected and the characteristics of it.
H. If the specimen was sent to the lab or not.
I. Client's response to the procedure (subjective and objective information).
B. The last time the client voided and the amount.
C. If the client had any bladder distention.
D. What the nurse did (catheterization procedure)
E. Size of the catheter used.
F. If an indwelling catheter is used, document how much fluid is in the balloon.
G. How much urine was collected and the characteristics of it.
H. If the specimen was sent to the lab or not.
I. Client's response to the procedure (subjective and objective information).
References
Bermanm, A., Snyder, S., Kozier, B., & Erb, G. (2011). Fundamentals of nursing: Concepts, process and practice (9th ed.).
Upper Saddle River, NJ: Pearson Prentice Hall.
Berman, A., Snyder, S., Kozier, B., & Erb, G. (2008). Fundamentals of nursing: Concepts, process and practice (8th ed.).
Upper Saddle River, NJ: Pearson Prentice Hall.
Bermanm, A., Snyder, S., Kozier, B., & Erb, G. (2011). Fundamentals of nursing: Concepts, process and practice (9th ed.).
Upper Saddle River, NJ: Pearson Prentice Hall.
Berman, A., Snyder, S., Kozier, B., & Erb, G. (2008). Fundamentals of nursing: Concepts, process and practice (8th ed.).
Upper Saddle River, NJ: Pearson Prentice Hall.