The document provides a comprehensive overview of the procedure for female urinary catheterization, including its purpose, assessment, equipment needed, and step-by-step instructions. It emphasizes the importance of using the appropriate catheter size based on patient needs and outlines hygiene protocols throughout the procedure. The main goal is to maintain urinary elimination with an adequate output, ensuring patient comfort and safety during the process.

1. Female Urinary
Catheterization

2. Definition
Urinary Catheterization
Is the introduction of a catheter into the
urinary bladder.

3. Purpose of urinary catheterization:
■ To relieve discomfort due to bladder
distention or to provide gradual
decompression of a distended bladder
■ To assess the amount of residual
urine if the bladder empties
incompletely
■ To obtain a sterile urine specimen
■ To empty the bladder completely
■ To facilitate accurate measurement
of urinary output for critically ill
clients whose output needs to be
monitored hourly.
To provide for intermittent or
continuous bladder drainage and/or
irrigation.
To prevent urine from contacting an
incision after perineal surgery.

4. ● Determine the most appropriate method of catheterization based on
the purpose, size of catheter base on the doctors order.
● Used a straight catheter if only a one time urine specimen is needed
or temporary decompression/emptying of bladder.
● Use an indwelling/retention catheter if the bladder must remain
empty.
● Determine when the client last voided was or was last catheterized.
● If catheterization is being performed because client is was been
unable to void.
● Assess the overall client condition.
Assessment:

5. Selecting a
Urinary Catheter
Appropriate size of
catheter
● Determine the appropriate
length: adult female client -
use a 22cm catheter
Adult Male- use a 40 cm
catheter.
● Determine appropriate size
by the size of the urethral
canal.
● Children french # 8 or # 10
● Adults French # 14 or # 16
● Men larger size # 18.

6. Types of urinary
catheter

8. Equipments
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-Sterile Foley catheter
-Sterile gloves
-Antiseptic solution; betadine
-cleansing cherries
-forceps
-ky jelly or water soluble lubricant.
-kidney basin
-specimen container
For indwelling catheter
-10 ml syringe
-urinary bag/collection bag
-bank blanket or cloth for draping
-sterile water

9. goal :
The client’s urinary elimination is maintained, with a urine
output of at least 30 ml/hour and the client’s bladder is not
distended.

11. Procedure:
1. Review the client’s chart for any limitations in physical
activity. Confirm the medical order for indwelling catheter
insertion.
2. Bring the catheter kit and other necessary equipment to the
bedside. Obtain assistance from another staff member, if
necessary.
3. Perform hand hygiene and put on PPE, if indicated.
4. Identify the client.
5. Close the curtains around the bed and close the door to the
room, if possible. Discuss the procedure with the client and
assess the client’s ability to assist with procedure. Ask the
client if she as any allergies, especially to latex or iodine.

12. Procedure:
6. Provide good lighting. Artificial light is recommended (use of a
flashlight requires an assistant to hold and position it). Place a trash
receptacle within easy reach.
7.Adjust the bed to a comfortable working height, usually elbow
height of the caregiver (patient safety center 2009). Stand on the
client’s right side if you are right handed, stay at the client’s left side if
you are left-handed.

13. Procedure:
8. Assist the client to a dorsal recumbent position with knees
flexed, feet about 2 feet apart, with her legs abducted. Drape
client. Alternately, the Sims’, or lateral position can be used.
Place the client’s buttocks near the edge of the bed with her
shoulders at the opposite edge and her knees drawn toward
her chest. Allow the client to lie on either side, depending on
which position is easiest for the nurse and best for the
client’s comfort. Slide waterproof pad under client buttocks.

14. Procedure:
9. Put clean gloves. Clean the perineal area with
washcloth, skin cleanser, and warm water, using a
different corner of the washcloth with each stroke.
Wipe from above orifice downward toward the
sacrum (front to back). Rinse and dry. Remove
gloves. Perform hand hygiene again.
10. Prepare urine drainage setup if a separate
urine collection system is to be used. Secure to bed
frame according to manufacturer’s directions.

15. Procedure:
11.Open sterile
catheterization tray on a
clean overbed table using
sterile technique.

16. Procedure:
12. Put on the sterile gloves. Grasp upper
corners of drape and unfold drape without
touching unsterile areas. Fold back a corner on
each side to make a cuff over gloved hands. Ask
client to lift her buttocks and slide sterile drape
under her with gloves protected by cuff.

19. Procedure:
13. Based on facility policy,
position the fenestrated
sterile drape. Place a
fenestrated sterile drape
over the perineal area,
exposing the labia.
14. Place sterile tray on
drape between
client’s/patient’s thighs.

20. Procedure:
15.Open all the supplies. Fluff cotton balls in
tray before pouring antiseptic solution over
them. Alternately, open package of
antiseptic swabs. Open specimen container
if specimen is to be obtained.
16. Lubricate 1 to 2 inches of catheter tip.

21. Procedure:
17. With thumb and one finger of non dominant
hand, spread the labia and identify meatus. Be
prepared to maintain separation of labia with one
hand until catheter is inserted and urine is flowing
well and continuously. If the client/patient i sin
the side-lying position, lift the upper buttock
and labia to expose the urinary meatus.

23. Procedure:
18. Use the dominant hand to pick up a cotton ball or
antiseptic swab. Clean one labial fold, top to bottom (from
above the meatus down toward the rectum), then discard the
cotton ball. Using a new cotton ball/swab for each stroke,
continue to clean the other labial fold, then directly over the
meatus.
19. With your uncontaminated, dominant hand, place the
drainage end of the catheter in receptacle. If the catheter is
free attached to sterile tubing and drainage container
(closed drainage system), position catheter and setup
within easy reach on sterile field. Ensure that clamp on

27. Procedure:
20. Using your dominant hand, hold the catheter 2 to 3 inches from
the tip and insert slowly into the urethra. Advance the catheter until
there is a return of urine (approximately 2 to 3 inches [4.8 to 7.2]).
Once urine drains, advance catheter another 2 to 3 (4.8 to 7.2 cm).
Do not force the catheter through the urethra into the bladder. Ask
the client/patient to breathe deeply, and rotate gently if slight
resistance is met as catheter reaches external sphincter.
.

29. Procedure:
21. Hold the catheter securely at the meatus
with your nondominant hand.. Use your
dominant hand to inflate the catheter balloon.
Inject entirely the volume of sterile water
supplied in prefilled syringe.
22. Pull gently on catheter after balloon is
inflated to feel resistance.
23. Attach catheter to drainage system if not
already pre-attached.

30. Procedure:
24. Remove equipment and dispose
of it according to facility policy.
Discard syringe in sharps container.
Wash and dry the perineal area as
needed.
25. Remove gloves. Secure catheter
tubing to the client’s/patient inner
thigh with velero leg scrap or tape.
Leave some slack in cather for leg
movement.

31. Procedure:
26. Assist the patient to a comfortable
position. Cover the client/patient with bed
linen. Place the bed in the lowest position.
27. Secure drainage bag below the level of
the bladder. Check the drainage tubing is
not kinked and that movement of side rails
does not interfere with catheter or
drainage bag.

32. Procedure:
28. Put on clean gloves. Obtain urine
specimen immediately, if needed. From
drainage bag. Label the specimen. Send
urine specimen to the laboratory
promptly or refrigerate it.
29. Remove gloves and additional PPE,
if used. Discard all used supplies in
appropriate receptacles. Perform hand
hygiene.

33. Procedure:
30. Document the catheterization procedure including the catheter
size and results in the client record using forms or checklist
supplemented by narrative notes when appropriate.

34. Thank You!