College of Health Sciences Education

3rd Floor, DPT Building

Matina Campus, Davao City
Telefax: (082)
Phone No.: (082)300-
5456/300-0647 Local 117

Name of Procedure:
URINARY CATHETERIZATION (MALE & FEMALE)

The introduction of a urinary catheter through the urethra into the bladder for
Definition:
instillation or removal of fluids.

1. To relieve urinary retention.

2. To obtain a sterile urine specimen.
Purposes:
3. To measure the residual urine remaining in the bladder after voiding.
4. To control urinary incontinence.
5. To provide access for instilling medication into the bladder.
6. To maintain an empty bladder during surgery.
7. To monitor hourly urine production in seriously ill clients.

a. External Douching tray

b. Bedpan with cover (plastic or metal)
c. Waterproof under pad
d. Bath blanket
e. A tray containing the following:

1. Pick up forceps in a disinfectant solution

Materials Needed: 2. Working forceps in a sterile pack
3. Lubricant
4. Betadine solution
5. Sterile dry CB- 1 packs
6. Catheter – (Fr. 12-14 for adults; Fr. 8-10 for children)
7. Sterile catheterization pack containing;
- Drape – fenestrated drape or eye sheet
- OS
- Kidney basin
8. Equipment for indwelling catheter:

- Foley catheter
- Sterile 5-10cc syringe filled with distilled water
- Triple distilled water vial
- Plaster
- Urine bag
-
f. Gooseneck lamp

No. STEPS: RATIONALE:

PERFORMING URINARY CATHETERIZATION: MALE CLIENT
1 Check the doctor’s order. Catheterization is only if with a medical orde
2 Assess whether client is allergic to iodine or plaster. Povidone iodine is often used to cleanse the
vulva before catheterization.
3 Assemble equipment needed. The organization promotes efficient time
management.
4 Identify and explain the procedure to the client. Ensures the right client and elicits
cooperation.
5 Provide a good light. Good lighting is necessary to locate the
meatus clearly.
6 Provide for privacy by screening and closing the The client has the right to be protected from
doors/ windows. being exposed to others.
7 Replace the top sheet with a bath blanket. Place a These protect the bed linen from moisture
waterproof underpad under the client. and getting soiled.
8 Place the client on a supine position with the feet Good visualization of the meatus is importan
apart and drape the client. Embarrassment, chilliness, and tension
interfere with the introduction of the catheter
9 Prepare the urine receptacle and tubing if an The tubing facilitates connecting the cathete
indwelling catheter is to be inserted. to the drainage system.
10 Open the pack and bring it near the perineal area. Placement of the equipment near the work
site increases efficiency.
Observe the aseptic technique.
The sterile technique protects the client and
prevents the spread of microorganisms.
11 Squeeze a small amount of lubricant over the sterile The organization promotes efficient time
OS and place in the sterile field. management.
12 Using sterile pickup forceps get 2 CBs with betadine
antiseptic solution from the sterile jar and place on
the sterile field on top of the several OS.

Open the wrapper/plastic cover of the sterile

specimen bottle and drop it on the sterile field
13 Wash hands and put on working gloves. Handwashing prevents the spread of the
microorganisms.
Do perineal care/flushing and discard working gloves
after cleaning the perineal area. Cleansing the perineal area prevents the
introduction of bacteria.
14. Put on sterile gloves. To avoid cross-contamination of
microorganisms.

Grasp the upper corners of the fenestrated or eye A drape provides a sterile field where the
drape and unfold it. Place the fenestrated drape equipment and hands will be placed.
aseptically over the perineal area with the penis Prevents accidental contamination from
extending through the opening. adjacent areas.
15 Holding the penis with the non-dominant hand.

Disinfect the meatus twice using CB with betadine

antiseptic solution. Cleans the area and minimizes the risk of
urinary tract infection by removing surface
pathogens.
Starting from the top use a circular motion stroke
 then downward for each CB and discard.
16 Lubricate 6-8 inches of the catheter tip ( avoid Lubrication facilitates the insertion of the
clogging the lumen) catheter and reduces trauma to the tissues.
17 Hold the penis perpendicular to the body and pull up
gently.
18 Hold the catheter in the dominant hand, and steadily Advancing an indwelling catheter an
insert the catheter about 8 inches, until urine is noted additional ½ inch to 1 inch ensures placeme
in the drainage bag or tubing. within the bladder and facilitates the inflation
of within the bladder and facilitates the
inflation of the balloon (if Foley catheter)
without damaging the urethra.
19 Do not force the catheter through the urethra.
Ask the client to breathe deeply and rotate the
catheter gently if slight resistance is met. The sphincter relaxes and the catheter can
enter the bladder easily when the client
relaxes.
20 Hold the catheter securely with your non-dominant
hand while the bladder empties. Collect a specimen
about 20-30 ml if required. Continue drainage
according to hospital policy.
21 Remove the catheter smoothly and slowly (a straight The catheter is only needed to drain urine
catheter is used) present in the bladder and is not intended fo
continuous use.
22 If a Foley catheter is used, introduce 5cc (or follow Creates a balloon to ensure catheter
the manufacturers to secure the catheter. Gently pull retention. Maximizes continuous bladder
the catheter until the retention balloon is snuggled drainage. Proper attachment prevents traum
against the bladder neck. (Resistance will be met). to the urethra and meatus from tension on th
Remove the fenestrated drape. tubing.
23 Attach the catheter to the urine bag below the level To avoid reflux of urine to prevent infection
of the bladder. (UTI).
Tape the catheter to the lower abdominal area.
24 Remove and clean the equipment.
Make the client comfortable.
Label the urine specimen and send it to the Urine kept at room temperature may cause
laboratory promptly. organisms if present, to grow and distort
laboratory findings.
25 Wash your hands. Handwashing prevents the spread of
microorganisms.
26 Record the time of the catheterization, the amount of A careful record is important for documentin
urine removed, a description of the urine; the client’s data after the client’s care.
reaction to the procedure, and other observations.
The reporting and recording of information
about the procedure must be accurate and
timely for continuity of care.
PERFORMING URINARY CATHETERIZATION: FEMALE CLIENT
1 Review the client’s health record. Check the client’s Catheterization is only if with a medical orde
chart for physician orders.
2 Identify the client and establish rapport. Ensures the right client and elicits
cooperation.
3 Assess the need of the client for catheterization.
4 Explain the procedure to the client. To elicit the cooperation of the client.
5 Provide a good light. Good lighting is necessary to locate the
meatus clearly.
6 Gather the needed equipment: Organization promotes efficient time
management.
7 Provide privacy by closing the door and pulling the The client has the right to be protected from
curtain. being exposed to others.
8 Replace the top sheet with a bath blanket. Place a These protect the bed linen from moisture
waterproof underpad under the client's buttocks. and getting soiled.
9 Place in a dorsal recumbent position with the feet Good visualization of the meatus is importan
apart and drape the client. Embarrassment, chilliness, and tension
interfere with the introduction of the catheter
10 Wash hands thoroughly and put on clean working Handwashing prevents the spread of the
gloves. microorganisms.
11 Do perineal care/flushing procedure, and remove Cleansing the perineal area prevents the
and discard used working gloves. introduction of bacteria.

Prevents the spread of the microorganisms.

12 Prepare the urine receptacle and tubing if an The tubing facilitates connecting the cathete
indwelling catheter is to be inserted. to the drainage system.
13 Open the catheterization pack and bring it near the Placement of the equipment near the work
perineal area. site increases efficiency.

Observe the aseptic technique. The sterile technique protects the client and
prevents the spread of microorganisms.
14 Squeeze a small amount of lubricant over the sterile The organization promotes efficient time
field. management.
15 Get 2 CBs from the pack and place them on the The organization promotes efficient time
sterile field. Then pour betadine over them. management.
16 Put on sterile gloves. To avoid cross-contamination of
microorganisms
17 Grasp the upper corners of the eye or fenestrated A drape provides a sterile field where the
drape and unfold it without touching unsterile areas. equipment and hands will be placed.
Prevents accidental contamination from
adjacent areas.
18 Place eye or fenestrated drape over the vulva area
exposing the labia.
19 Lubricate 1-2 inches of the catheter tip (avoid Lubrication facilitates the insertion of the
clogging the lumen) catheter and reduces trauma to the tissues.
20 With the thumb and forefinger of your non-dominant
hand, spread the labia and identify the urinary
meatus. Maintain the hold until the catheter has been
inserted.
21 With the dominant hand disinfect the meatus twice Cleans the area and minimizes the risk of
using CB with betadine. urinary tract infection by removing surface
pathogens.
22 Insert the tip of the catheter into the dimple-like
structures below the clitoris which is the meatus
about 2-3 inches or until urine flows. Do not force the
 catheter through the urethra. Ask the client to
breathe deeply and rotate the catheter gently if slight The sphincter relaxes and the catheter can
resistance is met. enter the bladder easily when the client
relaxes.
23 Hold the catheter securely with your non-dominant
hand while the bladder empties. Collect a specimen,
if required, Continue drainage according to hospital
policy.
24 Remove the catheter smoothly and slowly (if a The catheter is only needed to drain urine
straight catheter is used). present in the bladder and is not intended fo
continuous use.
25 If a foley catheter is used, introduce 5cc (or follow Creates a balloon to ensure catheter
manufacturer’s instruction) of distilled water to retention. Maximizes continuous bladder
secure the catheter. Gently pull the catheter until drainage. Proper attachment prevents traum
retention balloon is snuggled against the bladder to the urethra and meatus from tension on th
neck. (Resistance will be met.). Remove the tubing.
fenestrated drape.
26 Attach the catheter to the urine bag below the level To avoid reflux of urine to prevent
of the bladder. Tape the catheter to the thigh. infection(UTI).

27 Place the client in a comfortable position.

Handwashing prevents the spread of
Do aftercare of other equipment use. microorganisms.

Remove gloves and do hand washing. Urine kept at room temperature may cause
organisms if present, to grow and distort
laboratory findings.
Label the urine specimen and send it to the
laboratory promptly.
28 Documents the following: A careful record is important for documentin
Date and Time procedure started and ended. data after the client’s care.
Client’s response/reaction to the procedure.
Record the client’s output if required. The reporting and recording of information
about the procedure must be accurate and
timely for continuity of care.
REMOVING AN INDWELLING CATHETER
1 Check the order on the client’s chart. Removing of urinary catheter is only done if
with medical order.
2 Obtain a 5 to 10-ml syringe (depending on the size of
the balloon of the catheter) and an absorbent towel.
3 Wash hands. Handwashing prevents the spread of
microorganisms.
4 With the ticket, call out the client's name check the Ensures the right client and elicits
client’s identification band, and explain the cooperation.
procedure. Inform the client that there may be a
slight discomfort as the catheter is removed.
5 Don gloves. To avoid cross-contamination of
microorganisms
6 Place the absorbent towel on the mattress under the These protect the bed linen from moisture
catheter and attach the syringe to the balloon port. and getting soiled.
 Withdraw all the water or solutions from the balloon
7 Hold the absorbent towel in your non-dominant hand
in front of the perineum. Pinch the catheter near the
meatus with your dominant hand and pull it steadily
out onto the absorbent towel until the end is
retrieved. Hold the catheter at an upward angle to
the drainage tubing so that may urine in it will drain
into the drainage bag.
8 Inspect the catheter to make certain it is intact. If it is
not, notify the physician immediately.
9 Measure the output in the drainage bag. Record the
output on the I & O sheet. Empty the urine into the
toilet bowl and dispose the urine bag into the yellow
bin.
10 Remove gloves, wash hands and make the client Handwashing prevents the spread of
comfortable. microorganisms.

Instruct the client to drink extra fluid and warn that

there may be mild burning with the first few voiding.
Remind the client of the expected voiding time.
11 Document the time of removal and the time by which A careful record is important for documentin
the client should have the next voiding time. data after the client’s care.

The reporting and recording of information

about the procedure must be accurate and
timely for continuity of care.