URINARY CATHETERIZATION

Urinary Catheterization is the introduction of a catheter through the urethra into

the bladder for the purpose of withdrawing urine.
Purposes:
 To relieve urinary retention
 To obtain a sterile urine specimen from a woman
 To measure the amount of residual urine in the bladder
 To obtain a urine specimen when a specimen cannot secure satisfactory by other
means
 To empty bladder before and during surgery and before certain diagnostic
examinations
Necessary Equipment for Catheterization
 Catheters are graded on the French scale according to the size of the lumen.
 For the female adult, No. 14 and No. 16 French catheters  are usually used. Small
catheters are generally not necessary and the size of the lumen is also so small
that it increases the length of time necessary for emptying the bladder.
 Larger catheter distends the urethra and tends to increase the discomfort of the
procedure.
 For male adult, No.18 and No. 20 French catheters usually used, but if this
appears to be too large, smaller catheter should be used.
 No. 8 and No. 10 French catheters are commonly used for children.
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Preparation of the Patient

1. Adequate exploration.  On some instances, catheterization is the last resort, use

other techniques first for drawing out the urine before proceeding to
catheterization.
2. Position. Dorsal recumbent for the female and supine for the male using a firm
mattress or treatment table, Sim’s or lateral position can be an alternate for the
female patient
3. Provision for privacy
 Retention or Indwelling Catheter (Foley)

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 A catheter to remain in place for the following purposes:
1. The gradual decompression of an over distended bladder
2. For intermittent bladder drainage
3. For continuous bladder drainage
 An indwelling catheter has a balloon which is inflated after the catheter is
inserted into the bladder. Because the inflated balloon is larger than the opening
to the urethra, the catheter is retained in the bladder.

Procedure for Insertion:

1. Inflate the balloon with the prefilled syringe before inserting the catheter to
check for balloon patency. Aspirate the fluid back into the syringe when it is
determined that the balloon is patent.
2. Hold the catheter with one hand and inflate the balloon according to the
manufacturer’s instructions, as soon as the catheter is in the bladder and urine
has begun to drain from the bladder. Usually, 5 ml to 10 ml of sterile water is
used
3. If the patient complains of pain after the balloon is inflated, allow it to empty and
replace the catheter with another one. The balloon is probably located in the
urethra and is causing discomfort owing to distention of the urethra
4. Exert slight tension on the catheter after the balloon is inflated to assure its
proper placement in the bladder
5. Connect the catheter to the drainage tubing and drainage bag if not already
connected
6. Tape the catheter along the anterior aspect of the thigh for a female patient. Be
sure there is no tension on the catheter when it is taped to the patient
7. Hang the drainage bag on the frame of the bed below the level of the bladder
Caring for the Patient with an Indwelling Catheter 

1. Be sure to wash hands before and after caring for a patient with an indwelling
catheter
2. Clean the perineal area thoroughly, especially around the meatus, twice a day
and after each bowel movement. This helps prevent organisms for entering the
bladder
3. Use soap or detergent and water to clean the perineal area and rinse the area
well
4. Make sure that the patient maintains a generous fluid intake. This helps
prevent infection and irrigates the catheter naturally by increasing urinary output
5. Encourage the patient to be up and about as ordered
6. Record the patient’s intake and output
7. Note the volume and character of urine and record observations carefully
8. Teach the patient the importance of personal hygiene, especially the importance
of careful cleaning after having bowel movement and thorough washing of hands
frequently
9. Report any signs of infection promptly. These include a burning sensation and
irritation at the meatus, cloudy urine, a strong odor to the urine, an elevated
temperature and chills
10. Plan to change indwelling catheters only as necessary. The usual length of time
between catheter changes varies and can be anywhere from 5 days to 2 weeks.
The less often a catheter is changed, the less the likelihood than an infection will
develop

Removing the Indwelling Catheter and Aftercare of the Patient

1. Be sure the balloon is deflated before attempting to remove the catheter. This
may be done by inserting a syringe into the balloon valve or by cutting the
balloon valve
2. Have the patient take several deep breaths to help him relax while gently
removing the catheter. Wrap the catheter in a towel or disposable, waterproof
drape
3. Clean the area at the meatus thoroughly with antiseptic swabs after the catheter
is removed
4. See to it that the patient’s fluid intake is generous and record the patient’s intake
and output. Instruct the patient to void into the bedpan or urinal
5. Observe the urine carefully for any signs of abnormality
6. Record and report any usual signs such as discomfort, a burning sensation when
voiding, bleeding and changes in vital signs, especially the patient’s temperature.
Be alert to any signs of infection and report them promptly