Urinary Catheterisation - Male Flashcards
(1) Introduction:
What should not forget?
A chaperone
(2) Gather equipment:
Read list!!
- Plastic apron
- Two pairs of sterile gloves
- Sterile water-filled syringe (10ml) for inflation of the catheter balloon.
- 0.9% sodium chloride (10mls)
- Lidocaine (1%) anaesthetic lubricating gel for insertion into the urethra.
- Male urinary catheter (12/14 french): these are also used for females in most cases.
- Catheter pack: including cotton wool balls, sterile gauze, sterile drapes, absorbent pad and gallipot (a.k.a. a small pot).
- Catheter bag
- Urine collection bowl (a.k.a. a receiver)
(3) Positioning the patient:
Why should you get the chaperone to remove the sheet?
To maintain sterility.
(4) Cleaning the genital region:
Which hand should you use to pull back any foreskin?
How should you clean the urethral meatus?
What do you put on the patient once you have cleaned?
GLOVES SHOULD BE REMOVED ONCE YOU ARE DONE CLEANING
Non-dominant hand
With your dominant hand, pick up a cotton ball and use a single stroke moving away from the urethral meatus to clean an area of the glans
Place the sterile drape over the patient’s genitals, positioned such that the genitals remain visible through the central aperture of the drape. Some drapes come with a hole already present for this purpose, whereas others will require you to create one.
(5) Inserting the local anaesthetic:
What should you warn the patient about?
How long should you wait for it to kick in?
What should you do while you wait?
It may sting a bit
3-5 minutes
Continue to hold to the penis in the vertical position to ensure the gel remains within the urethra and allow 3 to 5 minutes for the lidocaine gel to reach its maximum effect.
(6) Inserting the catheter - Preparation:
How do you open pack for catheter?
How do you make sure remove the wrapper without pulling the catheter back out?
What might you reach that the patient will complain of some discomfort?
Remove the tear-away portion of the wrapper near the catheter tip, making sure not to touch the catheter.
The key to removing the wrapper without also pulling the catheter back out is to ensure you have a good grip on the penis as you gently pull back on the wrapper.
When you reach the prostate
(7) Inserting the catheter - Insertion:
How do you know once it has reached the bladder?
What is there is significant resistance?
What should be done to secure the catheter?
Bladder will begin to drain from the catheter
Consider repeat attempt or specialist input from urology
Balloon inflation
(8) Inserting the catheter - Balloon inflation:
Why should you ask them if they have discomfort as you are filling the balloon?
If the patient begins to experience discomfort during the injection of the water stop immediately as this may indicate the tip of the catheter is within the urethra.
