Overview
This lecture demonstrates the step-by-step procedure for inserting and removing an indwelling urinary catheter in a patient with a vagina and highlights important care and safety tips.
Patient Preparation & Positioning
- Position the patient in the dorsal recumbent (frog-leg) position for optimal access to the urethra.
- Prepare a sterile field using the outer bag as a potential waste container.
Sterile Technique & Kit Setup
- Open the catheterization kit without contaminating the sterile field.
- Place the drape between the patient’s legs, touching only the shiny (outside) side.
- Use the correct size sterile gloves, and don them without touching the outer sterile field.
Catheter Insertion Process
- Open the catheter tray and prepare all supplies: swabs, lubricant, syringe with saline, and catheter.
- Lubricate the catheter before insertion.
- Use sterile swabs to clean the labia: one swipe down each side, one down the center, discarding each swab after use.
- Keep the labia separated with the non-dominant hand after cleaning to prevent contamination.
- Insert the catheter until urine flows, then insert an additional 2-3 inches.
- Inflate the balloon with the attached syringe.
- Gently tug the catheter so the balloon settles at the bladder neck.
- Secure the catheter tubing to the patient’s leg and ensure patient comfort.
Catheter Removal Procedure
- Remove any securing devices or stickers.
- Withdraw fluid from the balloon using an empty 10 mL syringe.
- Place a protective pad under the patient to manage urine leakage.
- Carefully pull out the catheter and provide perineal care if needed.
Key Safety & Care Tips
- Visualize how large the inflated balloon is to avoid trauma to the urethra.
- Always withdraw the balloon fluid completely before catheter removal.
- Secure the catheter tubing to the leg to prevent accidental dislodgement and injury.
- Most catheters now have a Luer Lock Port for specimen collection; never collect urine from the drainage bag.
Key Terms & Definitions
- Dorsal Recumbent Position — Patient lies on their back with knees bent and legs spread.
- Sterile Field — An area free from microorganisms to perform procedures.
- Luer Lock Port — A secure connection port on the catheter for specimen collection with a syringe.
Action Items / Next Steps
- Review the steps in your clinical nursing skills deck.
- Practice setting up a sterile field and donning sterile gloves.
- Prepare for a practical demonstration or skills check.