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. post-operatively (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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