SDE: Clinical Guidelines Ch7G

Clinical Procedure Guidelines for Connecticut School NursesPrintable version | Back to Contents
7
Specialized Health Care Procedures

G. Catherization: Reinsertion of Indwelling Urinary Catheter

Definition

Replacement of a dislodged indwelling urinary catheter. An indwelling urinary catheter is inserted into the bladder to provide urinary drainage over a period from hours to weeks. It is attached to a closed drainage system that must be emptied periodically (AUA Foundation, 2011).

Purpose

To maintain patency of the indwelling urinary catheter and to ensure emptying of the bladder of urine as it accumulates in order to: minimize residual urine; decrease incidence of bladder infection; and to control incontinence.

Equipment

Sterile gloves; sterile Foley catheter; sterile water (10 cc); 10 cc syringe; disposable wipes or soap and water; urinal or receptacle for urine, if procedure is not performed on the toilet; water-based lubricant; towel or disposable blue pads to place under student, if procedure is done on a cot; leg bag or other urinary drainage system.

Procedure

Male Catheterization

  1. Grasp sides of penis below the glans.
  2. Clean the tip of the penis and urethra.
  3. Retract foreskin if uncircumcised.
  4. Gently stretch the penis upward.
  5. Lubricate the catheter.
  6. Have student take a deep breath.
  7. Slowly insert the catheter until urine begins to flow and then about an inch more.
  8. If you meet resistance, have the student take another deep breath and continue with insertion (resistance in male catheterization is normal at about the level of the prostate).
  9. If resistance continues or the student experiences pain, stop insertion. Never force the catheter.
  10. Inflate balloon with appropriate amount of sterile water.
  11. Pull gently on catheter until balloon is snugly against bladder neck.
  12. Attach catheter to leg bag or other drainage system.
  13. Attach catheter to thigh without tension on tubing.

Female Catheterization

  1. Expose the urethral opening.
  2. Clean the vulva and urethral opening.
  3. Lubricate catheter.
  4. Separate the labia minora to clearly see the urinary meatus.
  5. Have the student take a deep breath.
  6. Slowly insert the catheter until urine begins to flow, then advance about an inch more.
  7. Inflate balloon with appropriate amount of sterile water.
  8. Pull gently on catheter until balloon is snugly against bladder neck.
  9. Attach catheter to leg bag or other drainage system.
  10. Attach catheter to thigh without tension on tubing.

Delegation Decisions

According to the Connecticut Board of Examiners for Nursing, this task can only be performed by a school nurse, RN, or LPN (Board of Examiners for Nursing, 2002).

Select Nursing Considerations

In particular circumstances, nursing assessment may indicate that reinsertion of the catheter requires physician evaluation, such as when displacement is traumatic, (i.e., frank bleeding or swelling is present) or when reinsertion is difficult. It is recommended that the same size catheter be reinserted or as close a size as possible. If reinsertion is difficult or the decision is made not to replace the catheter, make sure the student is diapered or protected from soiling himself or herself or his or her clothing. A dry dressing may be used to cover a urinary stoma.

References

AUA Foundation, (2011). Managing bladder dysfunction with products and devices. Retrieved January 3, 2012.

Board of Examiners for Nursing, (2002) Meeting Minutes: January 16, 2002. Retrieved January 17, 2012.

 




Content Last Modified on 5/8/2015 2:55:10 PM