.catheterization

Cathetrization in detail

1. By:- Mr ASHOK DHAKA BISHNOI Director, JINC

2. Is the introduction of a tube or a catheter through the urethra into the urinary bladder to drain the bladder. Purpose:- To relieve bladder distention To empty bladder prior to delivery or abdominal surgery. To obtain sterile specimen

3. Anesthesized  or  sedated  for surgery or other medical care Urinary   incontinent  patients BPH Acute urinary retention. Paralysis or physical injury to use either standard toilet facilities or urinals. Following urethral surgeries Before and after  cesarean sections Before and after  hysterectomies On patients who had  genital  injury

4. Types of catheter 1.An indwelling catheter , also known as Foley catheter , is left inside the bladder to provide continuous urine drainage. Two way Three way:- A 3-way catheter for continuous bladder irrigation (CBI) is a type of indwelling catheter. It is inserted to irrigate the bladder to prevent obstruction ( i.e bleeding

5. 2. A straight catheter , is used when the catheter is to be inserted and removed immediately. 3.Condom catheter:- consists of a soft plastic or rubber sheath, tubing, and a collection bag for the urine. The sheath is placed over the penis and the collection bag is attached to the leg. Collects urine when there is no need for catheter insertion.

6. 4.A suprapubic catheter is a type of indwelling catheter. The suprapubic catheter is inserted into the bladder through a surgical incision made in the abdominal wall, right above the pubic bone.

7. Catheters Straight Suprapubic Indwelling Condom

8. URINARY  CATHETER SIZES . :- The French  scale  (Fr.) is used to denote the  size  of catheters .

9. Age   Weight (kg)   Foley (Fr)  0-6 months  3.5-7   6  1 year  10  6-8  2 years  12  8  3 years  14  8-10  5 years  18  10  6 years  21  12   8 years  27  12  12 years  varies  12-14 Female 14-16 Adult (Men) 16-18

10. Position – Dorsal Recumbent Position Male: supine position For female client:- Cleaning is done from urethral orifice to the anal orifice. For male client:- Retract the foreskin & draw the penis upward & forward at 90 angle to the client legs in order to strengthen the urethra. The urine drainage bag is kept below the level of bladder.

11. Lubricate catheter (2.5 to 5 cm for women) and 12.5 to 17.5 cm for men) * Note : there may be an order for lubricant containing local anaesthetic* Apply sterile drapes keep gloves sterile women: under buttocks and fenestrated over perineum men: over thighs and fenestrated over penis

12. 10-15 ml of fluid is inserted in the balloon of Foley’s catheter. Length of urethra:- Male :- It is about “19-20” cm long Female :- it is about “4” cm long & “6” mm in diameter. If the patient get bladder spasm and pain, gently manipulate the catheter to change the position of balloon resting on the neck of bladder. Rotate the catheter if urine is not passed out. During insertion of catheter if any obstruction experienced. Withdraw the catheter a little. rotate it and then reinsert it in to the bladder.