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D E B L I N A R O Y
M . S C . N U R S I N G 1 S T Y E A R
K . G . M . U I N S T I T U T E O F N U R S I N G
Catheterisation
Introduction
 Urine
 Bladder
 Silicone
 Latex
 Drainage
 Urethra
Review of the anatomy and the physiology
Definition
 In urinary catheterization a latex, polyurethane,
or silicone tube known as a urinary catheter is
inserted into a patient's bladder via the urethra.
Catheterization allows the patient's urine to drain
freely from the bladder for collection. It may be used
to inject liquids used for treatment or diagnosis of
bladder conditions.
Types of Catheterisation
 Indwelling catheters
 Intermittent catheterization
Types of catheters
 Folley’s catheter
 Robinson’s intermittent catheter
 TURP catheter
 Silicone catheter
 coudé catheter
 Condom catheter/ external catheter
 Suprapubic catheter
1. folley’s catheter
2. Coude
catheter
3. Irrigation
catheter
Silicon catheter
K 90 urinary catheter
Suprapubic catheter
Indications
 neurological condition or injury
 outlet obstruction
 intractable incontinence, or where other methods are
inappropriate or unsuccessful. ƒ
 Palliative care
 Chronic urinary retention
 Tissue viability and preserving skin integrity
Additional Risk Factors
 history of sexual abuse
 Heart defects
Product selection
 Size
 Length
 Drainage system
 Material
 Volume
 Catheter material
 Duration of catheterisation
Articles for catheterisation
Articles
 Single use disposable apron
 Catheter
 Sterile dressing pack
 Additional pair of single use disposable sterile gloves
 One pair of single use disposable non-sterile gloves
 Prescribed single use anaesthetic gel/ lubricant gel -
written on Patients Medication Administration Chart
 Drainage bag
 10 ml Syringe x 2 • single use sachet normal saline 0.9%
 If catheter is not prefilled - 10mls sterile water for
injection and green needle.
 Disposable Non-sterile Kidney dish .
procedure
Procedure of catheterisation
introduction
• Introduce yourself to the patient
identity
• Verbal confirmation of the patient
• Check the file and confirm
Explanation
• Explain the procedure to the patient
equipments
• Gather all the equipment.
• Check the type and size of the catheter
Allergies
• Check for the latex alleriges and
allergies to lubricants or xylocaine
decontaminate
• Hand washing
Lithotomy Supine
Positioning
sterility
• Open the sterile drapes and
place in position
• Cover the area with sterile
dressing and minimize the
exposure
CLEANING
• Place sterile drape
• Use separate cotton balls to clean the perineal region
lubrication
• Open the sterile packaging of the catheter
• Apply the xylocaine jelly on the tip to 4cms
Communicate
• With the pt. for cooperation and simultaneous
explanation.
Female Male
Procedure of insertion
procedure
Female Male
insertion
• Insert the
catheter
approximately 5-
6cms. Once
urine has started
draining insert a
further 3-5cms
balloon
• Inflate the
balloon
• Sterile water/
0.9% saline
water
insertion
• Insert catheter until
urine has started to
drain, then insert a
further 5cm or
almost up to the
bifurcation
balloon
• Inflate the balloon
• Sterile water/ 0.9%
saline water
• Measure the amount of urine
• Ensure the patient is comfortable and the genital
area is
Termination
• On completion of procedure remove and dispose of
PPE and the articles used according to the hospital
policy
recording
• Record information in patients
health records
education
• Give explanation on care of
catheters and reinforce
Documentation
• Complete recording
Suprapubic catheter
 A urinary catheter that is inserted supra-pubically
when urethral catheterisation is not indicated , it is
done after cystostomy has been done .
Hand
decontamin
ation and
meatal
hygiene
Changing
and
emptying
of leg
bags/valve
s
Patient
Education
Possible
signs and
symptoms
of
infection
Dietary
and fluid
advice
complications
 Incontinence
 Infection
 Sepsis
 Urethral injury
 Skin break down
 Hematuria
 Bladder cancer.
Prevention of infection
 Cleansing the urethral area
 clean hands
 Disconnecting drainage bag as seldom as possible.
 Keeping drainage bag connector as clean as possible
 Use of a thin catheter.
 Drinking sufficient liquid to produce at least two
liters of urine daily
 Sexual activity is very high risk.
Urethral trauma Pelvic fractures
Scrotal heamatoma High riding prostate
Contraindications
Note : in such cases one must then perform retrograde urethrography (injecting
20 cc of contrast into the urethra.) then go for catheterisation.
one must perform a
genital and rectal exam
first.
Summary
 Introduction
 Review of the anatomy and physiology
 Definition‘
 Types
 Indications
 Risk factors
 Articles
 Procedure
 Complications
 Prevention of infection
 Contraindications
Conlusion
Assignment
Discuss the nurses
responsibility in
catheterization.
Bibliography
 Black, Mary Ann (1994). Medical nursing (2nd ed.).
Springhouse, Pa.: Springhouse Corp. p. 97. ISBN 0-
87434-738-6. LCCN 94035389
 Royal Marsden Handbook of Clinical Nursing
Procedure 6th ed., London
 Association for Continence Advice (2007) Notes on
good practice Association for Continence Advice.
London
 Department of Health (2005) Saving Lives A
Delivery Programme to Reduce HCAI (including
MRSA) Retrieved from:http://www.dh.gov.uk
Thank you

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Catheterisation

  • 1. D E B L I N A R O Y M . S C . N U R S I N G 1 S T Y E A R K . G . M . U I N S T I T U T E O F N U R S I N G Catheterisation
  • 2. Introduction  Urine  Bladder  Silicone  Latex  Drainage  Urethra
  • 3. Review of the anatomy and the physiology
  • 4. Definition  In urinary catheterization a latex, polyurethane, or silicone tube known as a urinary catheter is inserted into a patient's bladder via the urethra. Catheterization allows the patient's urine to drain freely from the bladder for collection. It may be used to inject liquids used for treatment or diagnosis of bladder conditions.
  • 5. Types of Catheterisation  Indwelling catheters  Intermittent catheterization
  • 6. Types of catheters  Folley’s catheter  Robinson’s intermittent catheter  TURP catheter  Silicone catheter  coudé catheter  Condom catheter/ external catheter  Suprapubic catheter
  • 7. 1. folley’s catheter 2. Coude catheter 3. Irrigation catheter
  • 8. Silicon catheter K 90 urinary catheter Suprapubic catheter
  • 9. Indications  neurological condition or injury  outlet obstruction  intractable incontinence, or where other methods are inappropriate or unsuccessful. ƒ  Palliative care  Chronic urinary retention  Tissue viability and preserving skin integrity
  • 10. Additional Risk Factors  history of sexual abuse  Heart defects
  • 11. Product selection  Size  Length  Drainage system  Material  Volume  Catheter material  Duration of catheterisation
  • 13. Articles  Single use disposable apron  Catheter  Sterile dressing pack  Additional pair of single use disposable sterile gloves  One pair of single use disposable non-sterile gloves  Prescribed single use anaesthetic gel/ lubricant gel - written on Patients Medication Administration Chart  Drainage bag  10 ml Syringe x 2 • single use sachet normal saline 0.9%  If catheter is not prefilled - 10mls sterile water for injection and green needle.  Disposable Non-sterile Kidney dish .
  • 15. Procedure of catheterisation introduction • Introduce yourself to the patient identity • Verbal confirmation of the patient • Check the file and confirm Explanation • Explain the procedure to the patient
  • 16. equipments • Gather all the equipment. • Check the type and size of the catheter Allergies • Check for the latex alleriges and allergies to lubricants or xylocaine decontaminate • Hand washing
  • 18. sterility • Open the sterile drapes and place in position • Cover the area with sterile dressing and minimize the exposure
  • 19. CLEANING • Place sterile drape • Use separate cotton balls to clean the perineal region lubrication • Open the sterile packaging of the catheter • Apply the xylocaine jelly on the tip to 4cms Communicate • With the pt. for cooperation and simultaneous explanation.
  • 22. Female Male insertion • Insert the catheter approximately 5- 6cms. Once urine has started draining insert a further 3-5cms balloon • Inflate the balloon • Sterile water/ 0.9% saline water insertion • Insert catheter until urine has started to drain, then insert a further 5cm or almost up to the bifurcation balloon • Inflate the balloon • Sterile water/ 0.9% saline water
  • 23.
  • 24. • Measure the amount of urine • Ensure the patient is comfortable and the genital area is Termination • On completion of procedure remove and dispose of PPE and the articles used according to the hospital policy
  • 25.
  • 26. recording • Record information in patients health records education • Give explanation on care of catheters and reinforce Documentation • Complete recording
  • 27. Suprapubic catheter  A urinary catheter that is inserted supra-pubically when urethral catheterisation is not indicated , it is done after cystostomy has been done .
  • 29. complications  Incontinence  Infection  Sepsis  Urethral injury  Skin break down  Hematuria  Bladder cancer.
  • 30. Prevention of infection  Cleansing the urethral area  clean hands  Disconnecting drainage bag as seldom as possible.  Keeping drainage bag connector as clean as possible  Use of a thin catheter.  Drinking sufficient liquid to produce at least two liters of urine daily  Sexual activity is very high risk.
  • 31. Urethral trauma Pelvic fractures Scrotal heamatoma High riding prostate Contraindications Note : in such cases one must then perform retrograde urethrography (injecting 20 cc of contrast into the urethra.) then go for catheterisation. one must perform a genital and rectal exam first.
  • 32. Summary  Introduction  Review of the anatomy and physiology  Definition‘  Types  Indications  Risk factors  Articles  Procedure  Complications  Prevention of infection  Contraindications
  • 35. Bibliography  Black, Mary Ann (1994). Medical nursing (2nd ed.). Springhouse, Pa.: Springhouse Corp. p. 97. ISBN 0- 87434-738-6. LCCN 94035389  Royal Marsden Handbook of Clinical Nursing Procedure 6th ed., London  Association for Continence Advice (2007) Notes on good practice Association for Continence Advice. London  Department of Health (2005) Saving Lives A Delivery Programme to Reduce HCAI (including MRSA) Retrieved from:http://www.dh.gov.uk