Urinary Catheterization

 

Types:

  1. Straight or intermittent catheter
  • single lumen catheter inserted into bladder through the urethra only to empty the bladder, then is removed

 

Applications:

  • to determine residual volume
  • if pt cannot urinate related to urinary obstruction or neurological disorder such as spinal injury
  • patients use clean technique in home setting
  • in hospital sterile technique is used due to high nosocomial infection rate

 

  1. Indwelling (foley)
  • catheter is pre-connected or connected after insertion to a closed drainage system that acts as a reservoir for urine drainage.
  • In the foley, a separate lumen is used to inflate a balloon sot he catheter placement is maintained

 

Indications

  1. presence of stage 3 or 4 pressure ulcers that fail to heal as a result of continued incontinence
  2. When accurate measurement of urinary output in critically ill patients is needed
  3. relief of urinary obstruction
  4. postoperatively (spinal anesthesia, bladder injury)

 

Prior to insertion:

  • review patient’s history
  • check for physician’s order
  • determine previous catheterization and size

 

Assess:

  1. last time pt voided
  2. check I&O
  3. LOC
  4. Mobility and physical limitations
  5. gender and age
  • infant 5-6 French
  • child 8-10 Fr
  • adult female 14-16 Fr
  • young girl or woman 12 Fr
  • Men 16-18 Fr

 

  1. allergies
  2. Assess bladder for palpable distention above the symphysis pubis
  3. Use bladder scanner to determine post void residual
  4. Determine patient’s previous experience with catheterization

 

Post-insertion assessment

  • 30ml/hr

 

Documentation:

  • type and size of catheter
  • amt of fluid used to inflate catheter balloon
  • state reason for catheterization, specimen collection
  • patient’s response to procedure
  • patient’s understanding of teaching or self-care
  • start in and out record
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