M.M.

COLLEGE OF NURSING
MULLANA,AMBALA
CLINICAL DEMONSTRATION
ON
URINARY
CATHETERISATION

SUBMITTED TO: SUBMITTED BY

Ms Shikha Gulia Ms Diksha
(Assistant Professor in Medical Surgical Nursing) MSc Nursing 1st year
Roll No. 1923701
SUBMITTED
ON
15-1-2024
IDENTIFICATION DATA

Name: Diksha
Course : MSc Nursing 1st year
Rollno : 1923701
Subject : Medical Surgical Nursing
Topic: Urinary catheterization
Name of supervisor : Shikha Gulia
Duration: 30 minutes
Method of Discussion: Lecture cum Discussion Method
Previous Knowledge: Group might have some previous knowledge about the topic Urinary catheterization

Aim: To increase the knowledge of group about the topic: Urinary catheterization
General objectives: At the end of the teaching session, the group will be able to redemonstrate the Urinary catheterization
Specific objectives:
At the end of teaching, group will be able to gain some knowledge about topic: urinary catheterization

 To Introduce the topic of Urinary catheterization

 To define Urinary catheterization
 To explain indications of Urinary catheterization
 To explain contraindication of Urinary catheterization
 To discuss classification and sizes of catheters
 To explain preliminary assessment of Urinary catheterization
 To explain articles required in Urinary catheterization
 To explain the procedure of Urinary catheterization
 To explain the after care of Urinary catheterization.
 To summarize and conclude the topic.
[Link]. Time Specific Content Teaching Evaluation
objectives learning
activities
1. 30 Introduce self and My self Diksha
seconds announce the student of Msc
st
topic. Nursing 1 year.
Today I am going to
demonstrate the
topic- ‘Urinary
Catheterization’

2. 30 INTRODUCTION:
seconds introduce the topic Folly’s catheterization is commonly referred to an invasive Student teacher will be Introduce the
urinary procedure. It involves introducing a plastic or rubber tube into the able to introduce topic urinary
catheterization urethra than advance the tube into the bladder. Once in bladder the the urinary catheterization.
catheter provides continue flow of urine. catheterization with the
help of lecture cum
discussion
method
3. 30 define the DEFINITION: Define urinary
. seconds Urinary Student teacher will catheterization
catheterization URINARY CATHETERISATION: be able to define
It is the insertion of a catheter directly into the urinary bladder urinary
through the route of urethera. Catheterization

.
[Link]. Tim Specific Content Teaching learning Evaluation
e objectives activities

4. 3 enlist the INDICATIONS OF URINARY CATHETERISATION:

min indications of Student teacher will be What are the

catheterization. able to enlist indication indications of

 Intermittent catheterization: of catheterization urinary
catheterization.
 collection of sterile urine sample.
 Provide relief of discomfort from bladder distention.
 Decompression of bladder.
 Measure residual urine.
 Management of patient with spinal cord injury and
incompetent bladder.

 Short term indwelling catheter:

 Post surgery and in critically ill patient to monitor urinary

output
 Surgical procedure involving pelvic repair of bladder,
urethra
 Urinary obstruction
 Installation of medication into bladder.

 Long term indwelling catheter:

 Refractory bladder outlet obstruction and neurogenic
bladderwith urinary retention
 To promote healing of perineal ulcers where urine may
cause further skin breakdown.
[Link]. Tim Specific Content Teaching learning Evaluation
e objectives activities

CONTRAINDICATIONS:
 Urethral traumas
5.  Bleeding from inappropriate catheter size Student teacher will be What are the
2 explain  UTI related to poor sterile technique and long term contraindications of
min contraindicati able to explain
catheterization contraindication of catheterization?
utes on of urinary  Bladder spasms and pain. catheterization with the
catheterization  Bladder trauma help of lecture
 Severe hematuria cum discussion
 Patient refusal method.
 Low bladder compliance
[Link]. Time Specific Content Teaching learning Evaluation
objectives activities

6. 2 explain the Sizes of catheters:

minutes sizesof
catheters  5fr,6fr,8fr,10fr,12fr,14fr,16fr,18fr,20fr,22fr,24fr,26fr. Student teacher will What are the
 The higher the number the larger the diameter of catheter. able to explain the sizes sizes of
 In pediatric catheterization size 5,6,8,10fr or smaller of catheters catheters.
depending on the size of urethera and age of child,
 In male patients 16,18fr is commonly used. Because these
sizes catheters are more rigid and often easier to insert.
 In female patient 12,14,16 fr is typically used.

Student teacher will able Explain the

7. 5 discuss about CLASSIFICATION OF CATHETERS:
to explain about the classification of
minutes classification of classifications
 Two way Foleys catheter: catheters
catheters. of
catheters

Have an inflatable ballon that encircle the tip near the lumen.
[Link]. Time Specific Content Teaching learning Evaluation
objectives activities

 3 way Foleys catheter:

Also called retention catheter. One lumen drains the urine through
catheter into a collection bag. Second lumen used to inflate and
deflate ballon. Third lumen use to insert medication into bladder.

 CURVED CATHETER:

Use in older male patient with enlarged prostate with partially

obstructed urethra.
Sr no Time Specific Content Teaching Evaluation
Objectives learning
activities

8. 1 min explain the of Preliminary assessment Student teacher will Explain the
Preliminary able to explain the of
assessment of URINARY CATHETERISATION Preliminary Preliminary
urinary assessment of assessment of
 Check physician's order. urinary
cathaterisation urinary
 Identify the patient and check the purpose for the catheterization. catheterization
catheterization
 Check the specific precautions if any. and perineal
 Check the consciousness of the patient and the ability to follow instructions care?
 Check the general condition of the patent to maintain a desired position
 Check the articles available in unit including the availability of the light

9. 2 min explain the Student teacher Explain the

preparation of ARTICLE RATIONALE will be able to preparation of
articles of Perineal care: explain the articles of
urinary A sterile tray containing: preparation of urinary
catheterization.  A Small bowl containing cotton swabs. To clean the perineum articles of catheterization
perineal care and and perineal
 A bowl containing gauze pieces. care?
To hold the swabs for urinary
 Artery forceps catheterization
 Thumb forceps cleaning
 Kidney tray To discard the waste
Sr Time Specific Content Teaching Evaluation
no Objectives learning
activities

Article Rationale
Urinary Catheterization
A sterile tray containing

 Sterile gloves
To prevent from infection
 Sterile catheter of
appropriate size. To introduce into the bladder

 A small bowl
containing normal To clean the area
saline

 Cotton swabs dry and

wet. To dry the area
 Sterile
drape/fenestrated To protect soiling of bed sheet
towel.
 Artery forceps
To hold the swabs for cleaning
 Kidney tray
To discard the waste
 Lignocaine jelly
To lubricate catheter
 Gauze piece If an indwelling catheter is used
Sr Time Specific Content Teaching Evaluation
no Objectives learning
activities

Student teacherExplain how f

10 explain the Preparation of Patient will be ablepatient is
1 min
preparation of to explainprepared
patient before 1. Review the physician’s order and nursing care plan preparation of before urinary
urinary 2. Explain procedure to patient for the co-operation of patient patient beforecatheterization
catheterization 3. Adjust the position of the bed to comfortable working of nurse. urinary
4. Move patient to the edge of bed near to the nurse if patient is conscious. catheterization.
5. Place the patient in dorsal recumbent position.
6. Place the mackintosh & towel under patient.
7. Arrange articles conveniently.
8. Drape patient to provide privacy.
11
5min
Explain the Student teacher Explain the
Nursing Action Rationale will be ableprocedure of
procedure of Procedure to explain Urinary
Urinary 1. Wash hands and don the clean pair Reduces the risk of the procedure of fcatheterizatio
catheterization of gloves. transmission of organisms. Urinary n
2. Raise bed to appropriate working Promotes the use of correct catheterization
[Link] on right side of patient body mechanism.
and shift patient closer to you.
3. Position of patient: Provides good view of
a. Female: Dorsal recumbent with knees perineal structures. Prevents
flexed, and thighs externally rotated. tension of abdominal and
b. Male: Supine position with thighs slightly pelvic muscles.
abducted.
4. Wash perineal area/genitalia with Cleaning reduces the number
soap and water of microorganisms around
urinary meatus and possibility
of introducing
microorganisms with the
catheter
Sr Time Specific Content Teaching Evaluation
Objective learning
activities

Nursing Action Rationale

5. Steps of need-based perineal care:

a) Place mackintosh under the To prevent spillage and spread of

patient's buttocks. microorganism Cleaning from most
b) Open the perineal care tray. With clean to least clean areas ensures
the help of artery and thumb prevention of cross contamination.
forceps, pick a cotton swab and wet
it by dipping in the bowl of plain
water and clean the perineum
followed by cleaning with soapy
swab and again with wet swab.
c) Clean the perineum from the
outside to inside (labia majora-
labia minora urinary meatus and
vagina towards anus) in single
downward stroke each time To prevent spread of infection and
d) Dispose the soiled swabs. contamination.
e) Remove the gloves and dispose

6. Adjust spot light/flashlight to view

urinary meatus
7. Open the sterile tray (without Keeping all articles ready for use helps
touching inside of the sterile tray in saving time and prevents chance of
using sponge holding forceps), pour contamination.
antiseptic solution into bowl, open
outer cover of catheter and place in
tray if prepackaged.
Sr Time Specific Content Teaching Evaluation
Objective learning
activities

Nursing Action Rationale

8. Open lubricant, squeeze and discard First drop of lubricant may be

first drop and after that, drop some contaminated.
on a sterile gauze in the tray.
9. Don sterile gloves. Helps in preventing spread of
10. Drape perineal area, using microorganisms.
fenestrated towel.
11. Place sterile tray on drape between Provides easy access to supplies
patient's thighs.
12. If doing retention catheterization, fill Provides easy access to supplies,
the syringe with sterile water, if not checking balloon helps in identifying
already prefilled and test balloon of leaks in the balloon.
catheter by inflating it.
13. Deflate it and keep catheter aside
with syringe attached to it.
14. Open sterile specimen bottle and
sterile urine receiver ready for use in
the sterile tray.
15. Lubricate tip of catheter liberally Lubrication aids in easy insertion of
and place it in the sterile tray ready catheter by reducing friction.
for use
16. Clean meatus with antiseptic
solution if recommended by agency.
Sr Time Specific Content Teaching Evaluation
Objective learning
activities

Nursing Action Rationale

Female:
a. With nondominant hand, carefully Labia coming over meatus before
retract labia fully and expose catheter is in situ will cause
urethral meatus. Maintain the contamination
position of hand throughout the
procedure.
b. Using dominant hand, take sterile
cotton swabs dipped in antiseptic
solution and clean perineal area
from clitoris towards anus in the
following sequence-meatus, labia
minora and then labia majora
c. Use one swab for each wipe
d. Repeat cleaning with cotton swabs Removes disinfectant which can be
dipped in sterile normal saline in irritating to the skin and mucous
same sequence. membrane.
17. Record procedure and observation in Promotes communication between staff
patient's chart. members
Sr Time Specific Content Teaching Evaluation
Objective learning
activities

Procedure of Male Catherization

Nursing Action Rationale

1. Grasp penis firmly below the glans with Forskin coming back into position
nondominant hand Foreskin coming be before catheter is in situ will cause
Retract the foreskin and hold it contamination.
retracted till the end of procedure.
2. With dominant hand, use sterile swabs
dipped in antiseptic solution to clean
meatus and moving out in circular
motion.
3. Use one swab for each wipe.
4. Repeat the cleaning using sterile saline Disinfectant can be irritating to skin
in same sequence. and mucous membrane
5. Insert catheter for 15-25 cm in male
patients and 2.5-5 cm in female, until Male urethra is very narrow and flexing
urine begins to flow, do not force catheter can traumatize the sphincter
catheter. If met with resistance, twist and urethra. Deep breathing can aid in
catheter and wait for some time to muscle relaxation
allow sphincter to relax. Encourage
patients to take deep breaths while
inserting
6. Collect all urine in the sterile kidney Collecting urine helps in assessing the
tray, if needed, collect urine specimen volume of urine drained.
in the specimen container
7. Remove catheter if intermittent Inflated balloon helps in retaining
catheterization is done catheter inside the bladder.
8. If retention, catheterization is
performed, introduce sterile distilled
water to inflate balloon.
9. Pull Catheter outward lightly to
ascertain stability.
S.N Time Specific Content Teaching Evaluation
o. Objectives learning
activities

Nursing Action Rationale

10. Connect the catheter to urosac tied to bed Urosac above level of bladder
below the level of bladder will lead to back flow of urine
11. Fix catheter to thigh using adhesive tapes. and causes risk of infection.
Ensure adequate length to avoid traction
12. Clean and replace equipment and remove Keeps equipment ready for next
gloves. use.
13. Wash hands. Reduces risk of transmission of
14. Record procedure and observation in patient's microorganisms
chart. Promotes communication
between staff members

After Care :
 Wash and dry the perineum to remove any urine left on the skin.
 Remove the drapes, replace the garments and bed covers.
 Position the patient for correct body alignment.
 Make the patient comfortable.
 Take all articles to the utility room.
 Clean all articles.
S. Time Specific Content Teaching Aid Evaluation
No. Objectives
Role of nurse in Role of nurse in Cathater care Student teacher will be Explain the steps
12. 2 care of able to understand about to prevent
minutes catheterized 1. Perform hand hygiene immediately before and after handling thecare of patient patient from
patient the catheter or drainage system, and use clean gloves while catheter
handling the catheter or drainage system. infection

2. Perform peri-care using only lukewarm water or normal

saline
3. Keep the catheter and tubing from kinking and becoming
obstructed.

4. Keep the catheter system closed when using the urine

collection

5. Replacecatheters and urine collection bags that become

disconnected.

6. Ensure the resident's identifier and implementation date is on

her/his urine collection containers.

7. Disinfect the sampling port before obtaining a sample.

8. Educate residents and families about proper catheter care.

[Link]. Time Specific Content Teaching Aid Evalutaion
Objectives

13 2 Summary and . Summarisation:

minutes conclusion of Conclusion Today we learnt about the
catheterization introduction,definition,ind
Catheterization can be used when a person cannot empty their ication,contraindication
bladder without assistance, either permanently or on a temporary ,classification of
basis (such as after certain kinds of surgery). catheters, and sizes of
Patient has higher risk for development of infection through catheter, preliminary
catheter so nurse should take specific precaution to prevent from assessment,articles,steps
catheter associated urinary tract infection. of procedure,aftercare and
nursing responsibility of
urinary catheterization and
perineal care procedure
BIBLIOGRAPHY

 [Link]
 ttps://[Link]/tests-and-treatments/medicines-and-medical-aids/medical-aids/urinary-catheterisation
 Jacob Annamma,Rekha R,Tarachand sonali,Clinical Nursing Procedure book,Fourth edition jaypee publishers ;page no 365-368
 Potter and perry, “ textbook of nursing foundation”6th edition,elesvier publisher, page 540-545