Chapter 27, volumes one and two Catheterizations Chapter 27, volumes one and two

Catheterization Definition-the act of inserting or applying a hollow tube, usually for access to an internal structure. Used for drainage or instillation

Types of Catheterizations Bladder Intravenous Cardiac Central line, Picc line catheterization

Types of Urinary Catheters External (Texas catheter) Indwelling or retention (Foley catheter) Straight catheter

Types of urinary catheters

Urinary Catheterization Done for the following reasons: Incontinence (only if patient at risk for further breakdown or contamination) Distension, retention (bladder scan done first) Assessing fluid balance accurately Measuring residual urine Obtaining sterile specimens (mini catheterization)

Instilling medications, irrigating (example for a post-op or patient with cystitis) Resting the bladder after surgery Keeping the bladder empty during a procedure

Patient Concerns Pain Privacy Embarrassment Will it fall out? Ability to wear clothes (leg bag) Washing/showering

Undesirable Side Effects Infection Irritation/trauma Calculi formation Loss of muscle tone

How to Insert a Urinary Catheter into a Female Skill: See DVD 4 Refer to chapter 27, pages 643-645 And chapter 27, volume two

How to Insert a Urinary Catheter into a Male Patient Skill: - DVD 4 shows straight catheter insertion

Irrigating a urinary catheter Verify the medical order Use correct solution Skill DVD 4

A continuous irrigation: ongoing instillation of solution -instills irrigating solution into a catheter by gravity over a period of days -used to keep a catheter patent after prostate or other urologic surgery in which blood clots and tissue debris collect within the bladder -the three way catheter is necessary to provide a continuous irrigation -the catheter has three lumens or channels within the catheter, each leading to a separate port

Review of How to Give Catheter Care Follow agency protocal Wash with soap and water or follow agency protocol Wash from front to back in female and at center of urethra in male in circular motion going from center outward Wash catheter AWAY from the bottom, starting at urethra Secure/anchor catheter to leg following agency protocol

Discontinuing a Urinary Catheter Safely Know how much water was added to balloon Gather supplies-appropriate needle capacity, chux Explain procedure to patient Provide for privacy Aspirate water into syringe Gently glide catheter out of bladder once all water was removed from balloon

Patient Teaching Signs and symptoms of infection Increase fluids (also recommend acidic fluids) Clean intermittent self-catheterizations at home: clean technique some catheters can be reused (some disposable) clean catheter with soap and water following use, rinse and dry and store in dry place; soak catheter in white vinegar solution once weekly

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