1. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 4 Advanced Urinary Care Skills

2. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Urinary Catheters

3. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Reasons for Catheterization Surgery If the person cannot void because of temporary pain or swelling of the urethra (for example, following childbirth) If the urethra is blocked (for example, by an enlarged prostate gland)

4. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Reasons for Catheterization (cont.) To closely monitor urine output obtain a sterile urine specimen When the person is incontinent of urine pressure ulcers or other skin conditions that would be aggravated by contact with urine

5. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Risks of Urinary Catheterization Infection Urinary tract infection—most common type of HAI Urethral trauma

6. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins General Guidelines for Urinary Catheterization Doctor’s order is required A female patient is usually positioned in the supine position with her legs apart and knees slightly bent A male patient is usually positioned in the supine position Refer to Guidelines Box 4-1

7. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false. You do not need a doctor’s order to catheterize a patient. A. True B. False

8. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer B. False You must have a doctor’s order to catheterize a patient, including the type of catheter and the duration the catheter will remain in place.

9. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Indwelling Catheter

10. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Catheterization With an Indwelling Catheter An indwelling urinary catheter system is a closed system When passed through the urinary meatus and into the bladder, the balloon is inflated, which holds the catheter in place inside of the bladder A length of tubing connects the catheter to the urine drainage bag

11. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Disconnecting Catheter and Tubing

12. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which catheter is inserted in the abdomen to drain urine? A.Straight catheter B.Triple lumen catheter C.Suprapubic catheter D.Indwelling catheter

13. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer C. Suprapubic catheter This catheter is inserted via a surgical opening in the lower abdomen above the pubic area, into the bladder. It is often used when there is trauma or surgery to the urethral area.

14. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Collecting a Sterile Urine Specimen Urine from a just-inserted indwelling urinary catheter. The catheter tubing is clamped below the aspiration port so that urine collects in the tubing. A sterile syringe is inserted into the aspiration port and used to withdraw the urine specimen.

15. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Three Main Types of Irrigation Open Closed Continuous

16. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Open Irrigation

17. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Closed Irrigation

18. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Continuous irrigation Triple Lumen Catheter

19. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which irrigation is often used after prostate surgery? A.Open irrigation B.Closed irrigation C.Continuous irrigation D.Bolus irrigation

20. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer C. Continuous irrigation Continuous irrigation is used to keep the bladder flushed and prevent clots from forming in the bladder after surgery.

21. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Removing and Indwelling