Catherterization Flashcards
1
Q
What is bladder catherterization?
A
the insertion of a catheter into a patient’s bladder
- performed for both therapeutic and diagnostic purposes
- the urinary catheter can be either intermittent (short-term) or
indwelling (long-term)
- It can be performed by external, urethral, and suprapubic techniques
2
Q
Describe the 3 types of catheters?
A
- External catheters
- adhere to the external genitalia in men or pubic area in women to collect the urine. - Urethral catheters
- inserted through the urethra, with the tip advanced into the base of the bladder. - Suprapubic catheters
- inserted into the bladder surgically via a suprapubic approach.
3
Q
What are the indications for urethral catherterisation?
A
- a pre operative procedure,
- Relieve urinary retention
- For unwell patients to help measure their fluid input and output.
- Neurogenic bladder dysfunction
- Urinary incontinence
- Social and hygiene reasons
- Acutely ill patients requiring close urinary output measurement
- Chemotherapy drug delivery
- Bladder irrigation
4
Q
What are the potential causes of urinary retention?
A
- Obstructive
e.g BPH, stones, strictures, stenosis, or tumors. - Infectious & Inflammatory
e.g. Cystitis, urethritis, prostatitis, and vulvovaginitis. - Pharmacologic
Drugs with anticholinergic or alpha-adrenergic agonist properties. - Neurologic
Brain or spinal cord injury, cerebrovascular accident, multiple sclerosis, Parkinson disease, and dementia. - Others: Trauma, psychogenic, Fowler syndrome in women
5
Q
What are the diagnostic reasons for catheterizartion?
A
- Measurement of urodynamics
- Sample collection for urinalysis
- Radiographic studies (cystogram)
6
Q
What are the contraindications to bladder catheterization?
A
- Blood at the meatus
- Insertion of the catheter can worsen an underlying injury - Gross hematuria
- Evidence of urethral infection
- Urethral pain or discomfort
- Patient refusal
7
Q
What is the procedure for cathaterisation?
A
Note: A chaperone is required for this procedure.
- Begin by introducing yourself to the patient and clarify his identity.
- Explaining what you are going to do and obtain consent.
- Gather equipment
8
Q
What equipment is necessary for catheterisation?
A
Sterile gloves Sterile water Single-use lubricant and anesthetic gel Catheter Catheter bag Waterproof pad (disposable)
9
Q
What equipment can be found in a catheter pack?
A
2 pairs of sterile gloves Large disposable pad Sterile drapes Sterile cotton gauze swabs Sterile cotton wool swabs 12 – 20 Fr male Foley catheter catheter bag a 10ml saline-filled syringe antiseptic solution Sterile bowl Sterile water
10
Q
Describe the structure of a catheter?
A
- Composition: Silicone, latex, and PVC.
- Coating: Teflon, hydrogel, and antimicrobial or latex with a silicone elastomer coat
- Most catheters have dual-lumen tubes with one lumen draining the catheter and the other delivering water to the balloon.
11
Q
How do you prepare for a catheterisation?
A
- Review indications and contraindications for the procedure.
- Give clear instructions to the patient about the procedure.
- Allow appropriate time to respond to the queries of the patient.
- A proper light source should be present.
- Maintain patient’s privacy during the procedure.
- The patient should lie down on a firm flat surface with the head resting on a pillow.
- Appropriate positioning of the patient
- Supine position for men
- frog-leg position for women is recommended - Place a disposable pad beneath the patient’s buttocks.
- Perform hand hygiene.
- Wear sterile gloves.
- Appropriately drape the patient.
- Prepare the external genitalia:
- men: prepare the glans penis and the urethral meatus using a sterile technique
- women: use the non-dominant hand to expose the urethral meatus by separating the labia and prepare the meatus with an antiseptic solution.
12
Q
Describe the procedure to clean the male glans before catheterisation?
A
- Using an aseptic technique open the catheter pack and pour antiseptic solution into the receiver
- Open the rest of your equipment onto the sterile field.
- Pour antiseptic solution into the receiver
- Wash and dry your hands, then put on the sterile gloves
- Clean the glans using gauze swabs soaked in an antiseptic solution.
- Hold the penis with your left hand and clean the glans thoroughly
- Remember to retract the foreskin and clean around the urethral meatus
- Remove the gloves/ or maintain the same first pair.
- Wash your hands and apply the second pair of gloves
- Drape the patient with sterile drapes and place a collecting vessel between the patients legs
13
Q
Describe the procedure to clean the female genitalia?
A
- Using an aseptic technique open the catheter pack and pour antiseptic solution into the receiver
- Open the rest of your equipment onto the sterile field.
- Pour antiseptic solution into the receiver
- Wash and dry your hands, then put on the sterile gloves
- use your left hand, part the labia
- Using saline soaked gauze balls, clean the urinary meatus with your right hand.
- Remember to use single downward movements with each gauze.
- Remove the gloves/ or maintain the same first pair.
- Wash your hands and apply the second pair of gloves
- Drape the patient with sterile drapes and place a collecting vessel between the patients legs
14
Q
Describe the procedure to insert the catheter in a male?
A
- Hold the penis vertically with the left hand and with the other hold the catheter by its sleeve.
- Apply lubricant/water the catheter tip.
- Advance catheter tip from its sleeve and insert into the urethra
- Progressively insert the catheter, ensuring that neither your hand nor the sleeve touch the penis until the end arm
reaches the meatus. - At this point urine should start to flow into the collecting vessel
15
Q
Describe the procedure to insert the catheter in a female?
A
- With the labia parted, ensuring that you identify the meatus
- Using your right hand only, pick up the catheter by its sleeve and start to insert it into the meatus while its tip was lubricated.
- Continuing to use the sleeve, insert the catheter until the end arm reaches the meatus
- At this point, urine should start to flow into the collecting vessel
- Inflate the balloon using 10ml of saline, ensuring that it does not cause any pain.
- Note: the volume used to fill the balloon may vary depending upon the size of the catheter used, check the packaging for the exact volume to use
Attach the catheter bag. - Gently pull on the catheter until
resistance is felt. This is when the
balloon will be resting on the urethral
opening of the bladder.
•Then reposition the foreskin(if in males). - Dispose of your gloves and equipment
in the clinical waste bin - Wash your hands.
- Afterwards record the volume of urine
collected in the catheter bag and ensure
that the patient is comfortable and
covered.
