Definition:

Urinary catheterization is a procedure to introduce a catheter or tube through

urethra into the urinary bladder.

Types:

1. Intermittent

2. Indwelling

Indications for intermittent catheterization:

1. To relieve discomfort of bladder distention.

2. To obtain sterile urine sample.

3. Assess presence of residual volume when bladder empties incompletely.

4. Long term management of clients with spinal cord injuries, neuromuscular

degeneration etc.

Indication for indwelling catheter

1. Obstruction to urine flow.

2. Patients undergoing surgical repair of urethra.

3. Prevents urethral obstruction from blood clot.

4. Provides means to measure output in critically ill patients.

5. Provides continuous or intermittent bladder irrigations.

6. In cases of severe urinary retention and urinary incontinence.

Purposes

1. To get a sterile urine specimen for diagnostic purpose.

2. To empty the bladder when a condition of retention is thought to exist.

3. To determine whether the failure to void is due to suppression or retention.

4. To measure the amount of residual urine when the bladder is incompletely

emptied.

5. To empty the bladder prior to surgery involving rectum, vagina and pelvic
organs, thereby preventing injury to distended bladder.

6. To prevent urine from passing over a wound as in repair of the perineum.

7. To provide for intermittent or continuous bladder irrigation or drainage.

8. To manage incontinency when all other measures to prevent skin breakdown

have failed.

General instructions
1. Avoid catheterization unless it is ordered.

2. Follow strict aseptic technique to prevent UTIs.

3. Always use a rubber catheter.

4. Never use force.

5. Always catheterize in proper light.

6. Always do perineal care prior to catheterization.

7. Lubricate the catheter well.

8. Keep the patient relaxed by providing privacy and explaining the sequence
of the procedure.

9. Check purpose of catheterization.

10. Check the consciousness of patient for following commands.

11.Check for the articles available in the unit.

Articles required:

S.no Articles Rationale

A trolley containing
A sterile tray with
1 Sterile gloves To prevent contamination
2 Small bowls(02) To keep beta dine solution and
normal saline
3 Cotton swabs Used for cleaning perineum
4 Kidney tray(01) For placing in between thighs in
sterile area to keep distal part of
catheter
5 Long Artery forceps(01) For holding the swab and cleaning
the perineum.
6 Long Thumb forceps(01) For squeezing the betadine swab
and cleaning the perineum.
7 Cut sheet (01) For visualization of the particular
area to be used in procedure.
A clean tray containing
8 Mackintosh with towel (01) To prevent bedding and clothes from
soiling.
9 Drape sheet (01) To prevent unnecessary exposure of
patient.
10 Urobag (01) For collection of urine.
11 Xylocaine jelly For lubrication of urinary catheter.
12 Sterile specimen container (01) If sterile urine sampling is ordered.
13 Sterile syringe 20 ml (01) To fill sterile water for inflation of
 balloon.
14 Urinary Catheter’s size as per For introducing in urethra.
patient (01)
15 Flashlight For proper visualization of area.
16 Kidney tray(01) For collecting waste
17 Adhesive and scissors To stick the catheter and to cut the
adhesive.
18 Betadine solution To clean the perineum region.
19 Normal saline For cleaning perineum.
20 Screen For providing privacy.

Nursing procedure:
1. Identify the patient and assess the condition of patient.
2. Check for physicians order for special instructions
3. Explain procedure to patient
4. Maintain privacy
5. Bring articles near bed side
6. Position the patient and place mackintosh under buttocks of patients and
drape the patient.
7. Wash hands and wear sterile gloves.
8. Lift the draping sheet backwards towards abdomen
9. Open sterile tray with aseptic technique
10.Place cut open sheet and slit in position.
11.Place sterile kidney tray on sterile towel in front of patient.
12.Provide perineal care with aseptic technique
13. Keep the labia separated and pulled upwards from the time the vulva is
cleaned until catheter is introduced.
14.Pick up catheter with gloved hand holding it about 7.5 cm from tip and
place distal end in sterile kidney tray.
15.Apply Xylocaine jelly to lubricate the catheter approx 5-7 cm and gently
insert catheter about 5 -7.5cm.The urine will flow in kidney tray.
16.Release labia minora and hold catheter with small fingers or clamp it.
17.Instill 15-20ml of distill water or normal saline to inflate the balloon of
catheter.
18.Connect urobag to catheter and release the clamp or kink.
19.By use of adhesive fix the catheter and urobag
20.Reposition the patient for correct body alignment.
21. Replace all articles in utility room and clean them, wash hands and
document procedure.

References:

1. Jacob Annamma, Clinical Nursing Procedures: The Art of Nursing Practice, Edition
nd
2 , Jaypee Brothers Publication.
2. Kaur Maninder, Kaur Lakhvinder, Fundamentals Of Nursing, Edition-2014, 2015,
S.Vikas and CO. (Publishing House).
3. Thresyamma CP, Fundamentals of Nursing Procedure Manual for General Nursing
and Midwifery Course, Edition First, Jaypee Brother Publication.
4. Nancy Sr., Principles and Practice of Nursing, Vol-1, N.R.Brothers
publication.