Catheter & Wound Dressing Skills Check Offs

Initial steps upon entering the room for a urinary catheterization or dressing change procedure

Provide privacy, identify the patient, and explain the procedure.

Key patient assessment factors required prior to urinary catheter insertion

Assess urinary status, knowledge of the catheterization purpose, need for assistance, and allergies to iodine, Betadine, or latex.

Positioning for female urinary catheterization (primary and alternative)

Dorsal recumbent (primary); side-lying with the upper leg flexed at the knee and hip (alternative if dorsal recumbent is not tolerated).

Cleansing order and technique for female perineal preparation before catheter insertion

Front to back using a new cotton ball or swab per wipe: far labial fold $\rightarrow$ near labial fold $\rightarrow$ center of urethral meatus.

Lubrication length for a female urinary catheter

$2.5\text{ to }5\,cm$ ($1\text{--}2\,\text{inches}$).

Next step in female catheter insertion once urine flow appears

Advance the catheter another $2\text{--}3\,\text{inches}$ ($5\text{--}7.5\,cm$).

Correct patient positioning and drapery for male urinary catheterization

Position supine with thighs slightly abducted; cover the upper trunk with a towel and lower extremities with sheets so only the genitalia are exposed.

Method and volume of lubricant administration for male catheter insertion

Instill $10\,mL$ of lubricant directly into the male urethra.

Penis position and traction required during male catheter advancement

Position the penis perpendicular to the patient's body and apply light traction.

Proper insertion depth for a male urinary catheter

Advance the catheter through the urethral meatus to the bifurcation or "Y" level of the ports.

Required action if a catheter meets resistance during insertion

Do not force it; ask the patient to take deep breaths and gently rotate the catheter.

Protocol when catheterization yields more than $800\,mL$ of urine return

Clamp the catheter tubing for $10\,minutes$, then unclamp it.

Post-catheterization finding that requires immediate reporting

Complete absence of urine return.

Technique for removing old tape during a wet-to-dry dressing change

Pull the tape parallel to the skin, toward the dressing (do not pull against or away from the wound).

Critical wound findings during a dressing change that must be reported immediately

Brisk, bright red bleeding, or evidence of wound dehiscence or evisceration.

Proper technique for applying moist gauze in a wet-to-dry dressing

Apply moist fine-mesh gauze as a single layer directly onto the wound (moist but not dripping); gently pack deep wounds using cotton-tipped applicators without touching outer skin edges.