CATHETERIZING THE MALE PATIENT
SUPPLIES:
Foley
catheter kit with appropriate size catheter
Basin
with warm water
Soap
Towel
and washcloth
Tape
or catheter holder
Extra
light if needed
1. Check the physician’s order
for type and size of catheter. Assess patient’s knowledge of catheterization
and use of a catheter. Assess whether
patient is allergic to iodine or tape.
2. Check the patient’s
identiband, gather equipment, and prepare the working space by raising the bed
to proper height and positioning the over-bed table for use.
3. Close the door and/or
privacy curtains.
4. Explain the procedure.
5. Wash your hands.
6. With the patient supine and
knees slightly apart, drape by fanfolding the bedcovers down to cover the legs
exposing the perineal area. Use a bath
blanket to cover the trunk.
7. Open the catheter tray by
tearing open the plastic cover at the perforated line. Use the plastic cover as
a discard bag by placing it to the side of the field or toward the foot of the
bed.
8. Using sterile technique (opening
away from you), open the wrapper and use as sterile field for procedure.
9. Don sterile gloves.
10. Place the absorbent pad
under the penis, protecting sterile gloves; place the opening of the sterile
drape over the penis and onto the perineum.
11. Separate the two parts of
the kit.
12. Attach the sterile
water-filled syringe to the balloon port on the catheter and gently insert the
water to test the patency of the balloon.
13. After the test, draw the
water back into the syringe leaving the syringe attached to the catheter
balloon port.
14. Remove the plastic sleeve on the catheter by tearing it down the perforated side while carefully controlling the catheter. Place the catheter within the sterile tray where it can be easily reached.
**Remember when discarding trash to go around sterile field and “drop” into receptacle. Always stay at least 6” from anything nonsterile!!
15. Loosen the cotton balls one from another, open
the antiseptic solution pack, and drizzle antiseptic solution evenly over the
cotton balls. Discard the empty
package. Be careful not to splatter the
solution.
16. Lubricate around the first 3
to 4 inches of the catheter if the lubricant comes in a foil package. If it is in a syringe, squirt it directly
into the urethra.
17. Retract the foreskin if
necessary to expose the head of the penis.
Using forceps and a saturated cotton ball, grasp the glans below the tip
with the nondominant hand, hold it erect, and cleanse the glans in a circular
motion moving outward from the meatus.
Discard the used cotton ball and cleanse again with two more cotton
balls. Continue to hold the shaft of the
penis.
18. Pick up the catheter with
the dominant hand 3 to 4 inches below the tip.
With the penis at a 90-degree angle to the body, pull it slightly upward
and insert the catheter into the meatus about 8 inches using a rotating motion
until urine begins to flow.
19. If resistance is met, twist
the catheter and ask the client to take a deep breath. If resistance persists and the catheter will
not advance without difficulty, remove it and notify the physician.
20. Gently push the catheter in
1 to 2 inches more after urine starts to flow.
Hold the catheter in place with dominant hand and reach under dominant
hand with nondominant hand to inject the contents of the prefilled syringe into
the balloon and detach the syringe while holding the plunger all the way down.
21. Pull gently on the catheter
to check that the balloon is inflated.
Then push it back in slightly.
22. Clean the antiseptic
solution from the penis and remove the drape by tearing it toward the penis on
one side. Reposition the foreskin if it was retracted.
23. Tape the catheter to the
abdomen if it is to remain in place for an extended period. Alternatively it may be taped to the inner
thigh for short-term use.
24. Attach the drainage bag to
the bed frame (not the siderail). Coil
the excess drainage tubing on the mattress and secure it.
25. Remove the drape, make the
patient comfortable, lower the bed, raise the side rails, and restore the unit,
placing the call light within reach.
26. Dispose of used supplies in
the appropriate waste container.
27. Note the initial amount and
character of urine in the bag.
28. Remove gloves and wash
hands.
29. Was sterile technique
maintained? Was urine obtained? Were any problems encountered? Would you do anything differently next time?
30. Note date, time, size and
type of catheter inserted, amount of water in balloon, any problems
encountered, amount and character of urine obtained initially.