CATHETERIZATION.pptx ghhjjfhjfhfghhgggggg

How to cathetarize

1. CATHETERIZATION Presented by : Nassozi Maria Veneranda Kajokare Daniel Kwanyi

2. OBJECTIVES Definition of catheterization Identifying the types of catheterization as well as types and examples of catheters Identify pros and con’s of each type of catheter Identify the reasons for catheterization Possible complications of catheterization Demonstrate catheterization in both female and male patients

3. Catheterization This refers to a process of inserting a flexible tube called a catheter into the body , ie body cavity or passageway to allow fluids to flow through. Types of Catheterisation Urinary Catheterisation Cardiac catheterisation

4. Cardiac catheterisation A type of catheterization where a flexible tube (catheter) is inserted into a blood vessel in arm, groin , upper thigh or neck and guided through the aorta to the heart using a special x ray machine. This is done to diagnose and treat some heart conditions. (For our presentation we focused on the urinary catheterization since its more commonly done .

5. Urinary Catheterisation This refers to a procedure where a catheter is inserted either through the urethra or through a hole made surgically on the abdomen into the bladder to allow urine drainage from the bladder and collection. Note that Catheterisation is a sterile procedure.

6. Anatomy of male and female reproductive system showing routes for catheterization.

7. Types of Catheters Indwelling catheter : This type of catheters remain in place for weeks and are held in position by an inflated balloon in the bladder. Examples are the ; Indwelling urethral catheter which is inserted through the urethra to the bladder. Also called a foley catheter. Suprapubic catheter: This type is inserted through a small hole surgically made on the abdomen to the bladder.

8. Intermittent catheters: These are catheters designed for one time use. They are inserted through the urethra for as long as one needs to urinate. They are inserted multiple times a day. These do not have an inflatable balloon as in the indwelling ones. Condom catheters: This is a type of catheter which users wear outside the penis. It looks like a condom connected to a flexible tube to a drainage bag. Condom catheters have advantage of usually being more comfortable than indwelling.

9. Indwelling urethral catheter

10. Suprapubic catheter

11. Reasons for catheterisation Urinary retention or obstruction : this is due to a blockage like prostate enlargement Preoperative use in selected surgeries For accurate urine measurement in critically Ill patients Urinary incontinence In chemotherapy to directly deliver medicine to bladder in cases of bladder cancer. To drain urine during surgery

12. Contraindications of catheters A urethral catheter shall not be inserted when; There is urethral infection Injured urethra ( trauma ) Blood at meatus A condom catheter can’t be used if there is blockage in urethra

13. Disadvantages of catheterisation There is high risk of urinary tract infection especially in foley catheters. Bladder spasms and pain Urine leakage especially in condom catheters Skin conditions that range from mild irritation to necrosis.

14. Practical Requirements TOP SHELF BOTTOM SHELF In place Catheter of suitable size and material Urine drainage bag Hand washing equipment Sterile cotton balls, sterile forceps, Draw mackintosh and draw sheet Bins for waste mgt Sterile gallipots, sterile 10cc Catheter tip syringe Disinfectant Sterile water , lubricant gel 2 pairs of clean and 1 pair of sterile gloves Sterile drape , sterile sheets Kidney dish for used swabs , Sterile specimen container in case a urine sample is needed 2 sterile chitel forceps, saline solution

15. Preparation Confirm patient identity Perform risk assessment as well as the patient condition Choose the suitable catheter size and material for the patient Prepare and clean the trolley with disinfectant and gather all equipment needed for the procedure.

16. Procedure of inserting urethral catheter Step Rationale 1. Perform hand hygiene , also the assistant does the same 2. Greet and explain procedure to the patient or care taker, make sure they are comfortable with the procedure Assistant pushes trolley without touching the sterile part next to bed 3.Assistant puts up screens 4.Both dons pair of clean gloves. 5. Expose patient waist down. While maintaining patient dignity put draw mackintosh and draw sheet below patient buttocks. 6.Assistant exposes sterile field . Open sterile pack . Arrange contents respectively carefully using chitel forceps 7. Open sterile gloves pack drop onto sterile field, don them. Take sterile drape and cover patient exposing only organ.

17. Positioning the patient and cleaning them For male patient: Supine position with legs extended and legs slightly apart. A sling may be made from sterile gauze and placed round penis to aid mobility during procedure Clean the glans of penis and penile shaft from tip to base using cotton dipped in saline solution. For female patient: . Supine position , knees flexed ,legs apart to expose perineal region. Clean the labia both majora and minors, from in to out , and front to back.

18. 9. Doff gloves and perform hand hygiene 10. Assistant opens other pack of sterile gloves and drops onto sterile field. 11.Don sterile gloves, fill syringe with sterile water and attach it to catheter. 12. Place kidney dish between patient legs. Open sterile catheter pack Exposing first 6cm and lubricate with generous amount of lubricant gel. 13. Insert the catheter through the urethral opening till the bladder until urine flows out into the kidney dish.

19. Inject sterile water into the balloon inflation port to inflate the balloon. Gently tug at the catheter till you feel resistance. Check for any signs of discomfort. Attach catheter to drainage bag Ensure drainage bag is in position lower than bladder and patient is comfortable. Ensure patient is dry, remove drape and draw sheet and mackintosh . And cover patient Doff gloves. Perform proper waste management.

20. Putting on a condom catheter Follow the same procedure. Only for males However at putting on catheter, Strap catheter onto penis to secure it in position.

21. Suprapubic catheter Follow same basic procedure. Except, At insertion, the lubricated catheter is inserted through the hole on the abdomen. Drainage bag my be connected or not. The catheter may just be clamped and urine is disposed of directly in toilet basing on the mobility, or mental state of patient.

22. Removing catheter. Requirements Top shelf: Catheter tip syringe Scissors Gallipots of sterile cotton wool and saline solution 2 pairs of clean gloves. 2 pairs of sterile forceps Sterile gauze ( if its suprapubic) Draw sheet and mackintosh on bottom shelf

23. Removing the catheter Procedure Greet and explain procedure to the patient, make them feel comfortable. Ensure that they have an empty bladder ( ask them) Screen patients bed to ensure privacy Perform hand hygiene and don clean gloves. Expose the patient waist down, place draw sheet and mackintosh below patient buttocks. Empty drainage bag if present. If urethral Catheter, position patient in the same way you did while inserting the catheter.

24. Check for the condition of the catheter, and perineal area or suprapubic area identify any infection, bruises, necrosis etc Doff gloves , and perform hand hygiene. Don clean gloves . Get the catheter tip syringe, position plunger between 0.5 and 1ml to ensure that plunger is not sunctioned at syringe base to allow for passive deflation. Attach tip of syringe to Inflation valve on catheter by gently pushing and then gently twisting to engage valve. Allow catheter balloon to dispel water passively The plunger will move on its own As syringe fills with water.

25. Do not pull on the plunger. Another method of deflating the balloon is to Use scissors and cut the balloon port and the water will flow out. Gently but steadily pull out the catheter. Check catheter for any signs of bleeding, if the tube is intact. Discard the tubing into the appropriate waste bin. Using forceps , clean the perineum area using swabs dipped in saline solution. Remove draw sheet and mackintosh Doff gloves and perform hand hygiene. Cover patient and leave them comfortable.

26. If suprapubic catheter, clean area with disinfectant lotion. We don’t clean perineal area with disinfectant .

27. References Barkara K. Timby (2009; Fundamental In Nursing And Skills And Conceps ; Lippincotts Practical Nursing 9 Edition https://www.brooklinecollege.edu/blog/a-step-by-step-guide-to-urinary-catheterization/ https://opentextbc.ca/clinicalskills/chapter/10-3-urinary-catheters/

28. Thank you very much. Anything not included in the slides has been said verbally.