GORDON COLLEGE

College of Allied Health Studies

BACHELOR OF SCIENCE IN NURSING

Name: ________________________________________ Section/Group: ___________________ Date:_______________

PERFORMING URINARY CATHETERIZATION

Purposes
1. To relieve discomfort due to bladder distention or to provide gradual decompression of a distended
2. To assess the amount of residual urine if the bladder empties incompletely
3. To obtain a sterile urine specimen
4. To empty the bladder completely prior to surgery
5. To facilitate accurate measurement of urinary output for critically ill clients whose output needs to be monitored hourly
6. To provide for intermittent or continuous bladder drainage and/or irrigation
7. To prevent urine from contacting an incision after perineal surgery

Equipment: • Urine receptacle

• Sterile catheter of appropriate size (extra catheter • Syringe prefilled with sterile water
should also be at hand) • Collection bag and tubing
• Sterile gloves • Clean gloves
• Waterproof drapes • Supplies for performing perineal cleansing
• Antiseptic solution • Bath Blanket or sheet for draping the client
• Cleansing balls • Adequate lighting
• Forceps
• Water-soluble lubricant

Rating Criteria
5 Correctly and independently performs procedure and states rationale.
4 Performs procedure and states rationale with minimal guidance.
3 Satisfactorily performs procedure with moderate guidance
2 Procedure incorrectly done without rationale.
1 Not performed.

PROCEDURE 5 4 3 2 1
1. Introduce self and verify the client’s identity using agency protocol. Explain to the client what you are
going to do, why it is necessary, and how she or she can participate.
2. Perform hand hygiene and observe other appropriate infection prevention procedures.
3. Provide for client privacy.
4. If using a catheterization kit, read the label carefully to ensure that all necessary items are included.
5. Apply clean gloves and perform routine perineal care to cleanse cross contamination. For women, use
this to locate urinary meatus relative to surrounding structures.
6. Remove and discard gloves. Perform hand hygiene.
7. Place the client in the appropriate position and drape all areas except the perineum.
Females: supine with knees flexed, feet about two feet apart, and hips slightly externally rotated if possible.
Male: supine, thighs slightly abducted or apart.
8. Establish adequate lighting, stand on the client’s right if you are right handed and left, if you are left
handed.
9. Open the drainage package of the collecting bag and place the end of the tubing within reach.
10. Remove and discard gloves. Perform hand hygiene.
11. Place a waterproof drape under the buttocks (female) or penis (male) without contaminating the center
of the drape with your hands.
12. Organize the remaining supplies.
13. Saturate the cleansing balls with the antiseptic solution
14. Open the lubricant package.
15. Remove the specimen container and place it nearby with the lid loosely on top.
16. Attach prefilled syringe to the indwelling catheter inflation hub. Apply agency policy and/or manufacturer
recommendation regarding retesting of the balloon.
17. Apply sterile gloves.
18. Lubricate the catheter 2.5-5cm for females, and 15-17.5cm for males and place it with the drainage inside
the collection container.
19. If desired, place the fenestrated drape over the perineum, exposing the urinary meatus.
20. Cleanse the meatus.
Female:
▪
Use your nondominant hand to spread the labia so that the meatus is visible. Establish firm but gentle
pressure on the labia.
 ▪
The antiseptic may make the tissues slippery but the labia must not be allowed to return over the cleaned
meatus.
▪
Use great care that wiping the client does not contaminate the sterile hand. Use a new ball for the opposite
side. Repeat for the labia minora.
▪
Use the last ball to cleanse directly over the meatus.
▪
Use your nondominant hand to grasp the penis just below the glans. If necessary, retract the foreskin.
▪
Hold the penis firmly upright with slight tension.
▪
Pick up a cleansing ball with forceps in your dominant hand and wipe the center of the meatus in a circular
motion around the glans.
▪
Use great care that wiping the client does not contaminate the sterile hand.
▪
Use a new ball and repeat three more times. The antiseptic may make the tissues slippery but the foreskin
must not be allowed to return over the cleaned meatus nor the penis be dropped.
21. Insert the catheter. Grasp the catheter firmly from the tip.
22. Ask the client to take a slow, deep breath and insert the catheter as the client exhales. Slight resistance is
expected as the catheter passes through the sphincter.
23. If necessary, twist the catheter or hold pressure on the catheter until the sphincter relaxes.
24. Advance the catheter 5cm farther after the urine begins to flow through it.
25. If the catheter accidentally contacts the labia or slips into the vagina, it is considered contaminated and a
new sterile catheter must be used. The contaminated catheter may be left in the vagina until the new
catheter is inserted to help avoid mistaking the vaginal opening for the urethral meatus.
26. Hold the catheter with the nondominant hand.
27. For an indwelling catheter, inflate the retention balloon with the designated volume.
28. Without releasing the catheter (and for females, without releasing the labia), hold the inflation valve
between the two fingers of your nondominant hand while you attach the syringe (if not left attached
earlier) and inflate with your dominant hand.
29. If the client complains of discomfort, immediately withdraw the instilled fluid, advance the catheter
farther and attempt to inflate the balloon again.
30. Pull gently on the catheter until resistance is felt to ensure that the balloon has inflated and to place it in
the trigon of the bladder.
31. Collect all urine specimen if needed.
32. For a straight catheter, allow 20-30mL mL to flow into the bottle without touching the catheter to the
bottle.
33. For an indwelling catheter preattached to a drainage bag, a specimen may be taken from the bag this
initial time only.
34. Allow the straight catheter to continue draining into the urine receptacle. If necessary, attach the
drainage of an indwelling catheter to the collecting tubing and bag.
35. Examine and measure the urine.
36. Remove the straight catheter when urine flow stops. For an indwelling catheter, secure the catheter
tubing to the thigh for female clients or the upper thigh or lower abdomen for male clients to prevent
movement on the urethra or excessive tension.
37. Hang the bag below the level of the bladder. No tubing should fall below the top of the bag.
38. Wipe any remaining antiseptic or lubricant from the perineal area. Replace the foreskin if retracted
earlier. Return the client to a comfortable position. Instruct the client on positioning and moving with the
catheter in place.
39. Discard all used supplies in appropriate receptacles.
40. Remove and discard gloves. Perform hand hygiene.
41. Document the catheterization procedure including the catheter size and results in the client record using
forms or checklists supplemented by narrative notes when appropriate .
TOTAL

Inserting Foley Catheter to a male patient:

https://www.youtube.com/watch?v=3yYj2a4DjiA

Inserting Foley Catheter to a female patient:

https://www.youtube.com/watch?v=IW4g_FNUZFM

How to remove an Indwelling Catheter:

https://www.youtube.com/watch?v=EEcMVPUZsoQ