This document provides information on urinary catheterization including the types, parts, indications, procedures, and complications of catheterization. It discusses the different types of catheters including intermittent, external, and indwelling catheters. It describes how to properly insert a transurethral catheter and notes key steps like explaining the procedure to the patient, gathering supplies, cleaning the area, lubricating the catheter, and inflating the balloon. Potential complications of catheterization like urinary tract infections are also reviewed.
In urinary catheterization a latex, polyurethane, or silicone tube known as a urinary catheter is inserted into the bladder through the urethra. Catheterization allows urine to drain from the bladder for collection. It may also be used to inject liquids used for treatment or diagnosis of bladder condition
A brief awareness and knowledge about the insertion of NGT nasogastric Tube and feeding through it.
It contains an introduction, procedure, equipment needed, method of feeding etc
In urinary catheterization a latex, polyurethane, or silicone tube known as a urinary catheter is inserted into the bladder through the urethra. Catheterization allows urine to drain from the bladder for collection. It may also be used to inject liquids used for treatment or diagnosis of bladder condition
A brief awareness and knowledge about the insertion of NGT nasogastric Tube and feeding through it.
It contains an introduction, procedure, equipment needed, method of feeding etc
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Urinary catheterisation is a procedure used to drain the bladder and collect urine, through a flexible tube called a catheter. Urinary catheters are usually inserted by doctors or nurses in hospital or the community
Urinary catheterization
Definition
Types of Urinary catheterization
Effects or risks of Urinary catheterization
Suprapubic catheterization
Intermittent catheterization
Caring for catheters
Signs and symptoms of Urinary tract infections
Catheterization Procedure by Anushri Srivastav.pptxAnushriSrivastav
Catheterization of the bladder involves introducing a latex or plastic tube through the urethra and into the bladder. The catheter provides a continuous flow of urine in patients unable to control micturition or those with obstructions. It also provides a means of assessing urine output in hemodynamically unstable patients. Because bladder catheterization carries the risk of UTI, blockage, and trauma to the urethra, it is preferable to rely on other measures for either specimen collection or management of incontinence.
Types of Catheterization.
Intermittent and indwelling retention catheterizations are the two forms of catheter insertion
INTERMITTENT CATHETERIZATION
introduce a straight single-use catheter long enough to drain the bladder (5 to 10 minutes
When the bladder is empty, you immediately withdraw the catheter.
COMPLICATION- increases risk of trauma and infection.
INDICATION- It is common for people with spinal cord injury or other neurological problems such as multiple sclerosis to perform self– intermittent catheterization up to every 4 hours daily for months or years.
UTI rate is lower than for patients with long-term indwelling catheters.
INDWELLING CATHETERIZATION-
remains in place for a longer period, until a patient is able to void voluntarily or continuous accurate urine measurements are no longer needed
The straight single-use catheter has a single lumen with a small opening about 1.3 cm ( 1 2 inch) from the tip.
. Urine drains from the tip, through the lumen, and to a receptacle.
An indwelling Foley catheter has a small inflatable balloon that encircles the catheter just above the tip. When inflated the balloon rests against the bladder outlet to anchor the catheter in place.
The indwelling retention catheter often has two or three lumens within the body of the catheter . One lumen drains urine through the catheter to a collecting tube. A second lumen carries sterile water to and from the balloon when it is inflated or deflated. A third (optional) lumen is sometimes used to instill fluids or medications into the bladder. It is easy to determine the number of lumens by the number of drainage and injection ports at the end of the catheter
A second type of intermittent catheter has a curved tip
A Coudé catheter is used on male patients who may have enlarged prostates that partly obstruct the urethra. It is less traumatic during insertion because it is stiffer and easier to control than the straight-tip catheter
Plastic catheters are suitable only for intermittent use because of their inflexibility
Latex catheters are recommended for use up to 3 weeks. Be aware of allergies.
Pure silicon or Teflon catheters are best suited for long-term use (2 to 3 months) because of less encrustation at the urethral meatus
Balloon sizes range from 3 mL (pediatric) to large postoperative volumes (75 mL). In adults the 5-mL and 30-mL sizes are the most common: The 5-mL size allows for optimal drainage, whereas the 30-mL size is used after pros
Objectives :
-List the indications and contraindications for urinary catheterization.
- Indicate the appropriate catheter type/size.
- Discuss the risks associated with catheterizations.
-Describe the equipment for female/male/pediatric urinary catheterization.
- Discuss a safe method of performing urinary catheterizations .
This is a simplified presentation done by Patrick Nkemba, a student of clinical medicine at Rockview University. it is the product his desire to make the work easier to all the members of his presentation group. It should be noted that no copy right was obtained for the information compiled in this presentation. Therefore, its not for commercial use.
the first receivers of this information are the members of the presentation group.
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5. The french scale (Fr) is used to denote
the size of catheter.
1 Fr is equal to 0.33mm in diameter.
The smaller the number the smaller the
diameter.
No: 10 Fr is used for children.
No: 14 & 16 used for female adults.
No: 20 & 22 used for male adults.
6. 1.Unconscious or intubated pt:
2.Acute urinary retention
3.Neurogenic bladder
4.Obstruction (of urethra by anatomical condition that make it
difficult to urinate , large cystocele, narrowing of urethra ,
kidney or bladder stones and blood clots
5.3rd and 4th degree UV prolapse.
6.Bladder irrigation following surgery.
11. This type of catheter is used to drain the bladder for short period of
time like 5 to 10 minutes. It can be inserted or removed several
times a day. Purpose of this catheterization is to drain urine from
bladder that is not emptying adequately.
INDICATIONS; Used to empty the bladder
• Just before normal vaginal delivery,
• Exploration,
• Evacuation.
• Manchester repair
• Prolapse surgery
• Before any perineal surgery
12. It is closed sterile system with catheter retention balloon that
is inserted through urethra or suprapubically for a period of
time defined as less than 30 days.
SITES FOR INDWELLING CATHETER
1.Transurethral
2.Suprapubic
TRANSURETHRAL:
Catheter inserted into the bladder via urethra. This is a typical
approach because process can be done by nurses.
13. Two way foley’s;
Three way foley’s;---Use to drain the bladder after
bladder or upper urinary tract surgeries to add continuous
irrigation capabilities.
These helps to remove tissue chips ,blood clots and other
debris from bladder after surgery.
Medications such as antibiotics can be introduce via
continuous drip method.
If irrigation is discontinued irrigation lumen can be closed
by clamp or catheter plug.
14. Explain reason for catheterization to the
patient and family
Explain whole procedure to pt and answer
any question about procedure if pt asked.
Check all allergies to latex and iodine.
Maintain privacy and adequate lighting.
15. GATHER ALL
EQUIPMENTS:
1.Foley’s catheter
2.Sterile drainage bag with sample
port and tubing.
3.Water soluble lubricant jelly
4.10c.c syringe with sterile water for
foley’s balloon
5.Sterile drapes, gloves, cotton balls
6.Sterile specimen cup and
7.Iodine
16. Female position:
Female urethra is shorter than male urethra.
Insertion of catheter is facilated by having the
pt on her back, adequate exposure of urethra
is obtained by flexing her knees, separate
them and placing her feet flat on bed. (Frog
lagged position).
Place the catheter set between the female pt’s
legs.
17. Open the prepackaged foleys packet.
Place drap under the pt’s hip plastic side down. Place
fenestrated drap over the pt expose only genital area.
Put sterile gloves.
open the packet of cleaning solution, saturate cotton balls
(use soap if Pt has allergy to iodine).
Hold the labia apart and with dominant hand ,clean the
urethral meatus with iodine in downward towards the anus
using single stroke.
Openlubricant,saturatedistalendofcatheterbutleaveitinsterile
packingtoreducetheriskofcontamination.
18. Hold the labia open and hold the catheter in dominant
hand, introduce tip into the urethral orifice in slightly
upwards and backwards direction, feeding it out off
sterile packaging.
insert catheter approximately 5-6 cm. If pt experience
any pain or discomfort stop procedure.
Once the urine start to drain insert the catheter upto
bifercation point to ensure that balloon is in the bladder
because inflation of balloon in urethra is painful.
Gently inflate the balloon with 10ml sterile water or
according to capacity of balloon. Inflation must be
painfree.
Withdraw catheter slightly to ensure catheter is in
bladder and secure.
Attached catheter to drainage bag.
Make pt comfortable, ensure bed is clean and dry,
dispose off equipment's in clinical waste bag.
Wash your hands.
19. Insertion of catheter into the bladder via
anterior abdominal wall. Incision is made
above the pubic bone and below the
umbilicus.
This process is done by urologist.
INDICATIONS:
Urinary retention after urethral injury.
Pt needs long term catheterization for bladder
dysfunction in neurological condition like
multiple sclerosis, spinal cord injury.
20. 1.1ST of all you will do x-ray or u/s to check any abnormality
around bladder area.
2.Prepare bladder area with pyodine or cleaning solution.
3.Locate bladder by gentlly feeling around the area.
4.Use local anesthesia to numb the area.
5.Insert catheter by using stamey device this helps to guide
catheter in with piece of metal called an obturator.
6.Remove obturator once the catheter is in the bladder.
7.Inflate balloon of catheter at the end with water to keep it
from falling out.
8.Clean the insertion area and stitches up the opening.
21. 1.Urine not draining properly.
2.Urine leaking out of catheter.
3.Small amount of blood in urine.
22. must include daily cleansing of the urethral area and the
catheter itself with soap and water (some hospital policies
may vary in agent used)
The area should also be thoroughly cleansed after all bowel
movements to prevent infection
Antimicrobial ointments are no longer used
23. UTI,
septicemia,
urethral injury,
skin breakdown,
bladder stones
and hematuria
Bacteriuria
Chronic renal inflammation
Pyelonephritis
Nephrolithiasis
Cystolithiasis
Bladder cancer may also develop after many years of catheter use
24. Indwelling catheters are leading cause of catheter
associated UTI.
Bacteria or fungi may enter the urinary tract via catheter
where they multiply and cause the infection.
CAUSES :
1. Catheter may contaminated on insertion.
2. Bacteria from bowel movement may get on catheter.
3. Urine in drainage bag may flow back to catheter.
4. Catheter may not be regularly cleaned.
25. • Cloudy urine
• Blood in urine
• Strong urine odor
• Urine leaking around the catheter
• Pressure, pain or discomfort in lower back or
stomach
• Fever , chills , vomiting or unexplained fatigue
26. CAUTI is diagnosed by urine test
1.URINALYSIS :Can detect blood cells in the urine. The
presence may signals any infection.
2.URINE CULTURE: Can detect any bacteria or fungi in
urine.
TREATMENT
1.Increases fluidintake
2.Antibiotics
3.Other symptomatic treatment
27. NURSING IMPLICATIONS/ MONITOR FOR COMPLICATIONS
Foul smelling urine Thick, cloudy urine with or without sediment
Painful urination (dysuria)Fever, chills Urethral swelling around
the catheter
Bleeding into or around the catheter
Catheter draining little or no urine despite adequate fluid intake
Leakage of large amounts of urine around the catheter
28. Troubleshooting a leaking catheter
May be caused by incorrect size of catheter (too small),
improper balloon size, or bladder spasms
If bladder spasms occur, check that the catheter is draining properly.
If no urine is detected in the drainage bag, the catheter may be
obstructed by blood or thick sediment, or kinking of the catheter or
drainage tube.
Irrigation or the catheter may be indicated
Other caused of urine leakage around the catheter include
constipation or impaction of stool, or UTI
29. Including:
1.Date and time
2.Reason for insertion
3.Catheter type
4.Balloon size and volume of water
5.Date of removal or change of catheter
6.Name and signature of health professional.
30. VIVA Q
CONDITIONS WHERE INTERMITTENT CATHETERIZATION IS PREFERABLE?
• To empty bladder in case of atonia or during 2nd stage,
• Relief of AUR,
• checking PVR,
• CISC [temporarily measure in cases of OAB],
• to obtain a sterile urine sample.
31. ?
Intermittent doesn't have a balloon & isn’t connected
with a bag.
PVR intermittent catheters may be more flexible.
Otherwise insertion procedure is the same.
For how long can we keep it in before replacement?
It depends, but up to 12 wks
32. How to reduce the risk of catheter related UTI?
Sterile technique, smaller effective size, closed drainage
system, early removal as possible, good hygiene [protocols].
NOT: antiseptic on urethral meatus [very irritable] or within
bag.
What is “French”?
French [F] is a scale measure of the catheter’s lumen,
reflecting inner diameter. 1F = 1/3rd mm.
N.B: Urinary catheter involves both Foley's & intermittent.
33. Cut the catheter above the bulb
Pass the canula beside the catheter and prick the balloon
Use urethral stylet to rupture the balloon
Why not normal saline for inflation of balloon bcs it
crystalize and balloon can not deflate
Why not air ---Bcs it is lighter and float not fix in neck of
bladder so cant drain properly
34. Q A urinary catheter is vigorously inflated in the urethra at the
time of caesarean section. Urine. leaks from the rupture into
which anatomical space?
A Laterally to the femoral triangles
B Into the vagina
C Into the peritoneal cavity
D Into the lesser pelvis
E Into the anterior abdominal wall and mons pubis
The answer is into the anterior abdominal wall and mons pubis.
This is the only route possible due to the anatomy of the
urethra