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How to Insert a Catheter

Posted on August 31st, 2009 by aileen
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A urinary catheter is indicated for patients suffering from urinary retention (see Urinary Incontinence). There are different types of urinary catheter. It’s very important to know which type of catheter is required for you to be able to determine the right length and french size to use.

Lengths and Sizes

For Females

  • The ideal length for an intermittent and indwelling catheter for female is 6 inches, but some may require a longer catheter.
  • The french size for an intermittent catheter is between 8fr and 24 fr. An indwelling catheter is usually 12fr-18 fr.

For Males

  • An indwelling catheter for males should be 16 inches long with a french size of  12fr-26 fr.
  • An intermittent catheter is shorter by 4 inches with a french size between 10 fr and 24 fr.

Equipment

  • Sterile gloves
  • Drapes
  • Betadine or any cleansing solution
  • Cotton swabs
  • Forceps
  • 10 cc of sterile water
  • 10 cc syringe
  • Water-based lubricant
  • Foley Catheter
  • Collection bag and tubing

Preparation

  1. Gather all materials needed.
  2. Explain the procedure and its purpose to the patient
  3. Help the patient assume a supine position. For a female patient, it would be best to have her in a dorsal recumbent position. Ask the patient to lay on her back. Slightly lift her legs and bend her knees.
  4. Prepare your working area. Be sure to keep this area sterile at all times.
  5. Open the catheterization pack.
  6. Don gloves.

Skin Preparation

For Female Patients

  1. With your non dominant hand, part the labia to expose the peri- urethral area.
  2. Use forceps to clean this area with cotton swabs soaked in betadine solution or any agent that your institution requires.
  3. Use a downward motion when cleaning. Get a fresh cotton swab for each stroke you make.
  4. Clean the area from top to bottom, starting from the inner portion.

For Male Patients

  1. With your nondominant hand, position the penis so that it’s perpendicular to the body.
  2. Clean the tip of the penis and then the shaft.

Inserting the Catheter

  1. Apply a water-based lubricant on the tip of the catheter.
  2. Ask the patient to relax by breathing deeply and exhaling slowly.
  3. Insert the catheter gently. For a female patient, be sure that you’re correctly inserting the catheter in the urethral meatus.
  4. If  there’s resistance, stop the procedure and the let the patient relax for a few seconds. Reinsert the catheter.
  5. A urine flow would indicate that you’ve inserted the catheter correctly. Advance the catheter a couple of inches further.
  6. Fill the syringe with 10 cc of sterile water and inject this in the catheter to inflate the balloon. Check if 10 cc is the right amount for the catheter you’re using. Some may require a lesser or greater amount.
  7. Try to pull the catheter gently to check if it’s positioned correctly.
  8. Attach the drainage bag to the tubing. Keep in mind that the drainage bag should be lower than the patient’s bladder. Don’t let the bag touch the floor.
  9. Secure the catheter to the thigh or abdomen of the patient. Be sure to give adequate allowance for the patient to move without pulling the catheter out of place. Check also for kinks which may cause obstruction and backflow of urine to the bladder.
  10. Document the procedure and assess the color and amount of urine.

Inserting a urinary catheter should be done in a sterile manner. Don’t forget to wash your hands before and after the procedure. Drape your patient to provide privacy and comfort. If you’re interested in learning this article, you’ll surely learn more from reading how to insert an IV.

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