Tuesday, April 16, 2024

CATHETERIZATION OF A MALE PATIENT

Table of Contents

REQUIREMENTS #

  1. A trolley containing the following:
    • Top Shelf: A sterile pack or field containing the following:
      • Two gallipots
      • Three sterile drape, one sterile fenestrated drape
      • Sterile cotton wool swabs
      • Artery forceps
      • Kidney dish
    • Bottom Shelf: Various catheters of different sizes used
    • 14″ and 16″ for female
    • 18″ and 20″ for male
    • 8″ and 10″ for children
    • Lubricant (e.g. K.Y. or xylocaine jelly)
    • Diluted antiseptic solution
    • Receiver for used swabs
    • Mackintosh and dressing towel
    • Urine bag
    • Sterile water
    • Specimen bottles if necessary
    • Hypo-allergic tape or plaster
    • Light source
    • Sterile gloves
    • 10-20mls syringe and needle
    • Spigot if necessary
    • Jug of warm water and bowel/bucket
    • Bedpan
    • Soap and towel
    • Intake and output chart (manual or electronic)
  2. Condom catheter
  3. Urinal

STEPS #

  1. Review doctor/physician’s order for catheterization
  2. Establish rapport with patient (Refer to steps)
  3. Explain procedure to patient (Refer to steps)
  4. Provide privacy
  5. Perform hand hygiene
  6. Prepare and send trolley to the bedside
  7. Protect bed with mackintosh and dressing towel
  8. Perform hand hygiene and wear gloves
  9. Instruct assistant to place patient in the supine position with knees flexed and legs separated
  10. Cover patient’s upper body with a top sheet and fold the down over to expose the penis
  11. Place bedpan under patient, wash and dry perineal area thoroughly with soap and water
  12. Where necessary retract the prepuce so that the urethral meatus is exposed
  13. Clean patient and remove bedpan
  14. Remove the gloves and perform hand hygiene
  15. Open the packs of sterile dressing and catheter container and place the contents onto the sterile field
  16. Drape with a sterile towel and place the fenestrated drape over the penis exposing the urinary meatus
  17. Wear new sterile gloves
  18. Clean the area with antiseptic lotion wiping with backward motion from the urethral meatus
  19. To straighten the urethra, lift the penis to an angle of 90°
  20. Lubricate catheter with K.Y. or xylocaine jelly
  21. Insert the catheter gently for about 16cm or until urine begins to flow leaving the open end in the receiver between the patient’s thighs
  22. Inflate the balloon of the catheter with the sterile water according to manufacturer’s direction when urine flows out
  23. Collect a urine specimen if necessary and allows 20 – 30mls to flow into bottle without bottle touching the catheter
  24. Note: Slight resistance will often be met as the catheter encounters the external sphincter, therefore paus briefly and encourage the patient to breathe in deeply resulting in sufficient relaxation for the catheter to be passed readily for the urine to flow
  25. Connect catheter to urine bag
  26. Hang urine bag to the bed and secure in position
  27. Observe colour and note amount of urine
  28. Remove drapes, mackintosh and dressing towel
  29. Remove gloves and perform hand hygiene
  30. Assist patient into a desirable position
  31. Dispose off used items, decontaminate and trolley
  32. Perform hand hygiene
  33. Document the procedure, urine output and any abnormalities in the nurses’ note, intake and output chart (manual or electronic)