Don Mariano Marcos Memorial State University

South La Union Campus

I N S T I T U T E O F C O M M U N I T Y H E AL T H AN D AL L I E D M E D I C AL S C I E N C E S
Agoo, La Union
Tel. 072.682.06.63 / ichams.dmmmsu-sluc.com

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Standards NURSING DEPARTMENT care

Name: __________________________________ Date: _______ Year: ________ Rating:

Urinary Catheterization
CHECKLIST
Legend:
3-Very Satisfactory 1- Needs Improvement
2-Satisfactory 0- Did not perform the procedure
Preparation 3 2 1 0
1. Assess:
The client's overall condition.
If the client is able to cooperate and hold still during the procedure.
If the client can be positioned supine, with head relatively flat.
When the client last voided or was last catheterized.
Percuss the bladder to check for fullness or distension.
2. Determine: The most appropriate method of catheterization.
3. Assemble Equipment and Supplies:
Sterile catheter of appropriate size. An extra catheter should also be at hand.
Catheterization kit or individual sterile items:
1-2 pairs of sterile gloves
waterproof drape(s)
antiseptic solution
cleansing balls
forceps
water-soluble lubricant
urine receptacle
specimen container
for an indwelling catheter:
syringe prefilled with sterile water in amount specfied by the catheter's manufacturer
collection bag and tubing
2% Xylocaine gel (if agency permits)
Disposable clean gloves
Supplies for performing perieneal cleansing
Bath blanket or sheet for draping the client
Adequate lighting - obtain flashlight or lamp, if necessary
4. Perform routine perineal care to cleanse the meatus from gross contamination.
Procedure
1. Introduce yourself, and verify the client's identity. Explain to the client what you are going to
do, why it is necessary, and how the client can cooperate.
2. Perform hand hygiene, and observe other appropriate infection control procedures.
3. Provide for client privacy.
4. Place the client in the appropriate position, and drape all areas except the perineum:
Female: Supine, with knees flexed, feet about 2 feet apart, and hips slightly externally rotated.
Male: Supine, legs slightly abducted.
5. Establish adequate lighting. Stand on the client's right if you are right-handed, on the client's
left if you are left-handed.
6. If using a collecting bag not contained within the catheterization kit, open the drainage
package, and place the end of the tubing within reach.
7. If agency policy permits, apply clean gloves, and inject 10-15 ml Xylocaine gel into the urethra
of the male client. Wipe the underside of the shaft to distribute the gel up the urethra. Wait the
underside of the shaft to distribute the gel up the urethra. Wait at least 5 minutes for the gel to
take effect before inserting the catheter. Remove gloves.
8. Open the catheterization kit. Place a waterproof drape under the buttocks (female) or penis
(male) without contaminating the center of the drape with your hands.
9. Apply sterile gloves.
10. Organize the remaining supplies:
Saturate the cleansing balls with the antiseptic solution.
Open the lubricant package.
 Remove the specimen container, and place it nearby, with the lid loosely on top.
11. Attach the prefilled syringe to the indwelling catheter hub, and test the balloon.
12. Lubricate the catheter, and place it with the drainage end inside the collection container.
13. If desired, place the fenestrated drape over the perineum, exposing the urinary meatus.
14. Cleanse the meatus.
Note: the nondominant hand is consideredcontaminated once it touches the client's skin.
Female:
Use your nondominant hand to spread the labia. Establish a firm but gentle position.
Pick up a cleansing ball with the forceps in your dominant hand, and wipe one side of the
labia majora in an anteroposterior direction.
Use a new ball for the opposite side.
Repeat for the labia minora.
Use the last ball to cleanse directly over the meatus.
Male:
Use your nondominant hand to grasp the penis just below the glans. If necessary, retract
the foreskin. Hold the penis firmly upright, with slight tension.
Pick up a cleansing ball with the forceps in your dominant hand, and wipe the center of
the meatus in a circular motion around the glans.
Use a new ball, and repeat three more times.
15. Insert the catheter:
Grasp the catheter firmly 2-3 inches from the tip. Ask the client to take a slow deep
breath, and insert the catheter as the client exhales.
Advance the catheter 2 inches further after the urine begins to flow through it or per
agency policy.
If catheter accidentally contacts the labia or slips into the vagina, it is considered
contaminated, and a new sterile catheter must be used. The contaminated catheter may
be left in the vagina until the new catheter is inserted to help avoid mistaking the vaginal
opening for urethral meatus.
16. Hold the catheter with the nondominant hand. In males, lay the penis down onto the drape,
being careful that the catheter does not pull out.
17. For an indwelling catheter, inflate the retention balloon with the designated volume.
Without releasing the catheter, hold the inflation valve between two fingers of your
nondominant hand while you attach the syringe (if not left attached earlier when testing
the balloon), and inflate with your dominant hand.
If the client, complains of discomfort, immediately withdraw the instilled fluid, advance the
catheter further, and attempt to inflate the balloon again.
Pull gently on the catheter until resistance is felt to insure that the balloon has inflated and
to place it in the trigone of the bladder.
18. Collect a urine specimen, if needed. Allow 20-30 ml to flow into the bottle without touching the
catheter to the bottle.
19. Allow the straight catheter to continue draining. If necessary, attach the drainage end of an
indwelling catheter to the collecting tubing and bag.
20. Examine and measure the urine. In some cases, only 750-1000 ml of urine are to be drained
from the bladder at one time. Check agency policy.
21. Remove the straight catheter when urine flow stops.
For an indwelling catheter, secure the catheter tubing to the inner thigh for female clients
or the upper thigh/abdomen for male clients, with enough slack to allow usual movement.
Also secure the collecting tubing to the bed linens, and hang the bag below the level of
the bladder. No tubing should be fall below the top of the bag.
22. Wipe perineal area of any remaining antiseptic or lubricant. Replace foreskin, if retracted
earlier. Return the client to a comfortable position.
23. Discard all used supplies in appropriate receptacles, and perform hand hygiene.
24. Document the catheterization procedure including catheter size and results in the client
record.

Students Signature: ________________________ Evaluators Signature: _______________________

Comments: __________________________________________________________________________