Republic of the Philippines

PAMANTASAN NG LUNGSOD NG MAYNILA

(University of the City of Manila)
General Luna Street corner Muralla Street
Intramuros, Manila

COLLEGE OF NURSING
(Dalubhasaan ng Narsing)

Medical Surgical I – RGUT SKILLS LABORATORY CHECKLIST #5

Performing a Male Catheterization (Urethral/Straight Cath and Indwelling)

Name: ___________________________ Date: _____________________________

Year Level & Block: Clinical Instructor:__________________

Rating scale:

3 Performed correctly , systematically according to standard with correct rationale.

2 Performed correctly , systematically but with inadequate/incorrect rationale.
1 Performed incorrectly , not systematically with adequate/correct rationale.
0 Performed incorrectly/not done.

Purpose of the Procedure:

 Allows emptying of bladder

 Allows sterile urine specimens to be obtained
 Determines amount of residual urine in bladder
 Allows for continuous, accurate monitoring of urinary output
 Provides avenue for bladder irrigations

Special Considerations in Planning and Implementation:

 General: Never force a catheter if it does not pass through the urethral canal smoothly. If
the catheter still does not pass smoothly, discontinue the procedure and notify the doctor.
Forcing the catheter may result in damage to the urethra and surrounding structures.
 Pediatric: The bladder is higher and more anterior in an infant and small child than that an
adult. Common catheter size are 8 and 10 French. Catheterization is very threatening and
anxiety-provoking experience for children, so they need explanations, support, and
understanding.
 Geriatric: A common pathologic feature in elderly men is enlargement of the prostate
gland, which often makes inserting a catheter difficult.
 Delegation: In some agencies, catheterization may be delegated to specially trained
unlicensed personnel. Note agency policies concerning delegation of this procedure.
Reference-Source: Jean Smith-Temple and Joyce Young Johnson. Nurses’ Guide to Clinical Procedures 6th Edition
(Wolter Kluwers / Lippincott Williams and Wilkins)

Prepared by: Dr. Jennifer P. Reyes

AY 1st Semester 2020-2021
 Performing a Male Catheterization (Urethral/Straight Cath and Indwelling)

Preparation Rationale

1. Assessment should focus on the

following:

 Type of catheterization ordered (e.g.,

indwelling or straight for residual urine)
 Status of bladder (distention before catheter
insertion)
 Abnormalities of genitalia or prostate gland
 History of conditions that may interfere with
smooth insertion of catheter (e.g., prostate
enlargement, urethral stricture)
 Client allergy to iodine-based antiseptics
2. Equipment/Materials needed:

 Urethral catheterization set (includes sterile

gloves, specimen collection container,
catheter, two drapes, graduated
measurement receptacle, antiseptic
solution, cotton balls, forceps, lubricating
jelly)
OR
 Indwelling catheterization set (includes all of
the items in the urethral catheterization
except the graduated measurement
receptacle, plus it includes a drainage
collection system [tubing and bag that
connect to the catheter] and prefilled saline
syringe for balloon inflation)
 Basin of warm, soapy water
 Washcloth
 Large towel
 Sheet for draping
 Non-sterile gloves
 Linen saver
 Tape
 Commercial tube holder
 Bedpan, urinal, or second collection
container
 Specimen container, if specimen is needed
 Googes (for client unable to maintain urinary
control during procedure)
 Extra lighting
 Pen

Implementation of the Procedures:

 ACTION / STEPS of the Procedure

1. Prepare the equipment/materials needed.

2. Perform Hand Hygience.

3. Introduce self and Verify client’s identity.

4. Explain procedure to client.

5. Provide Privacy.

6. Determine if clients is allergic to iodine-based

antiseptics and use alternative, if indicated.
7. Don non sterile gloves.

8. If catheterization is being done for residual urine,

ask client to void in urinal, and measure and
record amount voided; empty urinal.
9. Lower side rails, assist client into a supine
position, and place linen saver under client’s
buttocks.
10. Wash genital area with warm, soapy water, rinse
and pat dry with towel.
11. Discard non sterile gloves, bath water, washcloth,
towel; perform hand hygiene.
12. Drape client so that only penis exposed.

13. Set up work field:

 Open catheter set and remove from outer

plastic package.
 Tape outer package to bedside table with top
edge turned inside out.
 Place catheter kit beside client’s knees and
carefully open outer edges.
 Ask client to open legs slightly.
 Remove full drape from kit with fingertips and
place across thighs, plastic side down, just
below penis; keep other side sterile.
 If catheter and bag are separate, use sterile
technique to open package containing bag and
place bag on work field.
14. Don sterile gloves.

15. Prepare items in kit for use during insertion as follows:

 Pour iodine solution over cotton balls.

  Separate cotton balls with forceps.

 Examine the catheter tip and, if intact,

lubricate 6-7 inches of catheter from tip down
and palce carefully on tray so that tip is secure
in tray.
 If inserting indwelling catheter, attach prefilled
syringe of sterile water to balloon port of
catheter.
 Inject 2-3 ml of sterile water from prefilled
syringe into balloon and observe balloon for
leaks as it fills.
 If any leaks are noted, discard and obtain
another kit.

 If balloon is intact, slowly deflate balloon, and

leave syringe connected.

 Attach catheter to drainage container tubing

(or, if drainage tubing is already attached to
the catheter, place tubing and bag securely on
sterile field, close to other equipment).
 Check clamp on collection bag to be sure it is
closed. Place catheter and collection tray close
perineum.
 Open specimen collection container and place
on sterile field.

16. Remove fenestrated drape from kit and place

penis through hole in drape with nondominant
hand. KEEP DOMINANT HAND STERILE.
17. Use nondominant hand to hold penis up at a 90
degree angle to client’s supine body
18. Gently grasp glans (tip) of penis; retract foreskin,
if necessary.
19. With forceps in dominant hand, cleanse meatus
and glans penis with cotton balls, beginning at
urethral opening and moving towards shaft of
penis; make one complete circle around penis
with each cotton ball, discarding cotton ball after
each wipe.
20. After all cotton balls have been used, discard
forceps.
21. With thumb and first finger of dominant hand,
pick catheter up about 1.5 – 2 inches from tip.
22. Carefully gather additional tubing in hand.
23. Ask client to bear down as if voiding and to take
slow deep breaths; encourage him to continue to
breathe deeply until catheter is fully inserted.
24. Insert tip of catheter slowly through urethral
opening 7 – 9 inches (or until urine returns).
25. If resistance is met:
 Stop for a few seconds.
  Do not force; remove cathter tip and notify
doctor if above sequence is unsuccessful.

26. If no resistance is noted, lower penis to about a 45

degree angle after catheter is inserted abot
halfway and hold open end of catheter over
collection container (if it is not connected to a
drainage bag).
27. After catheter has been advanced an appropriate
distance to obtain urine, advance catheter another
1 -1.5 inches.

For Straight Catheterization:

 Obtain urine specimen in specimen container if
ordered
 Allow remaining urine to drain until it stops or
until maximum number of milliliters specified
by agency (usually 1,000 – 1,500 ml) has drined
into container; use second container, bedpan,
or urinal, if necessary.
 For an indwelling Catheter:
 Inflate balloon wiht attached syringe and
gently pull back on catheter until it stops
(catches)
 Secure catheter loosely with tape to lower
abdomen on side from which drainage bag will
be hanging (preferablyaway from door); using
tape or catheter tube holder to secure
additional tubing to thigh; make certain that
tubing is not caught on railing locks and is not
obstructed.
28. Clear bed of all equipment.
29. Reposition client for comfort, and replace linens
for warmth and privacy as necessary.
30. Raise side rails and place call liht within reach.
31. Measure amount of urine in collection container
or drainage bag and discard urine and disposable
supplies
32. Gather and discard or restore all additional
equipment.
33. Remove and discard gloves and perform hand
hygiene.
36. Documentation:

The following should be noted on the client’s record

 Presence of distention before catheterization.
 Assessment of genitalia, if abnormalities noted.
 Types of catheterization and size of catheter.
 Amount, color, and consistency of urine
returned upon catheterization.
 Amount of urine returened before
catheterization (if residual urine
catheterizatio).
  Difficulties encountered, if any, in passing the
catheter smoothly.
 Reports of unusual discomfort during
insertion.
 Urine specimen obtained for culture.

Total Deduction or Demerit: ________ Total score: ____________________

I fully understand how I was graded for this particular skill and it was properly explained to me.

__________________________________________________ Date: ____________________

Student’s Full Name & Signature

I have explained and discussed how I have graded my students for this particular skill.

__________________________________________________ Date: ____________________

Clinical Instructor’s Full Name & Signature

Reference-Source: Jean Smith-Temple and Joyce Young Johnson. Nurses’ Guide to Clinical Procedures 6th Edition
(Wolter Kluwers / Lippincott Williams and Wilkins)

Prepared by: Dr. Jennifer P. Reyes

AY 1st Semester 2020-2021