Transcript URINARY CATHETERIZATION

URINARY
CATHETERIZATION
Outline
Review of Anatomy of Urinary System
Catheterization
* Definition
* Kinds of Catheter
* Purpose of Catheterization
* Guides in Selecting Catheter size
* Equipment for Catheterization
* Complications
* Prevention of Infection
The female urinary system
URINARY CATHETERIZATION
* Involves the introduction of a catheter (rubber or plastic tube)
through the urethra into the bladder
Catheterization should be performed as a sterile medical •
procedure by trained, qualified personnel
Kinds of Catheter
1-Intermittent catheter / straight
catheters
* Single lumen tube with a small eye or opening
from the insertion tip
* are placed into the bladder for short periods of
time (5-10) minutes (to empty bladder or take a
sample ) .
2
2-Indwelling/ Retention Catheter
A. Foley catheter
* double lumen catheter
* placed into the bladder for
extended periods of times.
* these catheters have a balloon
at the distal end that is inflated
after insertion and connected to
a closed gravity drainage
system.
B - Three –Way foley
catheter
Often used for continuous
bladder irrigation
3. CONDOM CATHETERS
* a condom-like device is placed over the penis; can be used by men with
incontinence;
* no tube placed inside the penis.
* A tube leads from this device to a drainage bag
* The condom catheter must be changed every day.
Purposes of Urinary Catheterization
1. To relieve acute or chronic urinary retention.
2. To empty bladder before, during and after surgery and
before certain diagnostic procedure.
3. To determine amount of residual urine after voiding.
4. To facilitate accurate measurement of urinary output of
critically ill patients for hourly monitoring.
5. To instill medications into the bladder.
6. To irrigate the bladder .
7. To obtain sterile urine specimen for diagnostic purposes.
Indications for Urinary Catheterization
1. Urinary incontinence (leaking urine or being unable to control when you
urinate)
2. Acute or chronic urinary retention (being unable to empty the bladder)
3. orthopedic procedures that may limit a patient's movement
4. benign prostatic hyperplasia
5. Surgery on the prostate or genitals
Guides in Selecting the Catheter
1-Plastic catheter - for short period ( 1 week or less .)
2- Rubber catheter - for period of 2-3 weeks .
3- Silicon catheter - for long –term use ( 2-3 months )
4- For adult female clients use 22-cm & 40-cm for male.
5- select the appropriate balloon size 10 ml for adult
* Catheters are sized according to the diameter of the lumen using
the French Scale
“The larger the number; the larger the lumen”
Foley catheter set
DRAINAGE BAGS
DRAINAGE BAGS
Assessment
1. palpate bladder to check for fullness or distention . Determine
when the client last voided .
2. Determine the size , type and balloon size according to the patient
'age , sex and purpose .
3. Check physician’s order for catheterization
4. Assess the client’s physical ability to cooperate with positioning
5. Assess urinary meatus for exudate, edema, inflammation, and
general cleanliness.
6. Assess need for perineal care before catheterization.
Complications
* Infection – normal defense mechanism through voiding is bypassed
* Trauma – if the catheter is forced through the strictures or at an incorrect
angle
* Allergy or sensitivity to latex
* Urethral injury
* Urinary tract or kidney infections
* Long term complications may include blood infections (sepsis), urethral
injury, skin breakdown, bladder stones, and blood in the urine (hematuria
Kidney damage ).
* After many years of catheter use, bladder cancer may also develop.
Preventing Catheter- Associated Urinary
Infections
Follow infection control Program
Catheterize clients only when necessary, by using aseptic technique, sterile equipment and trained
personnel
Maintain a sterile closed drainage system
Do not disconnect the catheter and drainage tubing unless necessary
Remove the catheter as soon as possible
Provide routine perineal hygiene, including cleansing with soap and water after defecation
Prevent contamination of catheter with feces in the incontinent clients
Keep the drainage bag lower than the bladder so that urine does not flow back up into the bladder.
Empty the drainage device at least every 8 hours, or when it is full.
Documentation
Type/ kind and time of catheterization
Amount, color, odor of urine obtained
Size of catheter used
Client’s tolerance of procedure
Specimen sent to lab
Catheter care provided
Condition of urinary meatus
video
https://www.youtube.com/watch?v=WNrMUEupTek
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and
Good Luck !