Clinical Skills Refresher-(look for the video that goes with this in my blog)
Performing a Urinary Catheterization:
Make sure you have a doctor's order!
Apply clean gloves and perform peri-care. Take this time to locate the urinary meatus.
Place client in appropriate position (females supine with knees flexed, feet about 2 feet apart, hips slightly externally rotated/males supine, thighs slightly abducted apart).
Stand on the right side if you are right handed, left side if left handed.
Apply your sterile gloves as described in previous video.
Organize your supplies: Saturate cotton balls with antiseptic solution/open pack of swabs. Open the lubricant package and dispense in appropriate slot in tray. Remove specimen cup and place nearby for use if needed.
Attach pre-filled syringe to the indwelling catheter inflation hub. Pre-test the balloon if it is your company policy.
Lubricate the catheter 1-2 inches from tip for females/6-7 inches for males. Set it in the tray.
Cleanse the meatus. Your non-dominate hand is now no longer considered sterile now that it has touched the client to spread the labia/hold the penis into position. Pick up a cotton ball with the provided forceps and wipe one side of the labia minora in an anteroposterior direction (or use the swab that's provided if your kit didn't come with the antiseptic/cotton balls/forceps). Use a new ball/swab for the opposite side. And use the last cotton ball/swap to wipe down the middle, over the meatus.
Remember! Don't let the outer labia touch after doing this...they must be kept separated to prevent contamination.
For males, using your non-dominant hand, grasp the penis just below the glans and hold firmly upright, with slight tension. Use the swabs/cotton balls and swab in a circular motion going from the meatus and working your way out. Do this three times total.
Remember! Don't let the foreskin retract or let go of the penis...it will then be considered contaminated and you'll have to start all over again!
Now with your still sterile, dominant hand; pick up the catheter and insert the catheter when the client exhales (have them inhale first). Advance the catheter about 2 inches further after the point urine begins to flow into the drainage tube.
Hold the catheter with your non-dominant hand and inflate the retention balloon to the designated volume.
If the client complains of pain: deflate the balloon, advance the catheter a little further and re-inflate. Remove the syringe from the hub and pull the drain to test for resistance.
Collect a urine specimen if needed from the drainage bag at this time (you can't do this from the bag later on because it will then be considered contaminated).
Important Things to Remember:
If the catheter accidentally touches/contacts the labia, slips into the vagina, the foreskin retracts, or that tip touches ANYTHING BUT MEATUS, start again. All over again.
