Catheterizing the Female Urinary Bladder Checklist

Step 1

Review client's chart for limitations in physical activity. Confirm the order for an indwelling urinary catheter.

Step 2

Perform ABCs, ensuring use of 2 client identifiers. Assess client's ability to assist with the procedure. Ask about allergies, including latex or iodine.

Step 3

Explain and provide education to client about the procedure

Step 4

Provide good lighting. Assemble equipment on overbed table or other surface within reach. Adjust bed to a comfortable working height, usually waist height of the caregiver. Stand on client's right side if you are right-handed, left side if you are left-handed.

Step 5

Assist the client to a position that accounts for their physical limitations and performing the catheterization (typically in a dorsal recumbent position with knees flexed, feet about 2 feet apart, legs abducted)

Step 6

Verbalize: Provide peri care

Step 7

Open sterile catheterization tray on the bed between the client's feet using sterile technique.

Step 8

Put on sterile gloves using the overbed table. Grasp upper corners of drape and unfold without touching nonsterile areas. Fold back a corner on each side to make a cuff over gloved sterile hands. Ask client to lift buttocks and slide sterile drape under buttocks, with gloves protected by cuff on the drape, shiny side down. Sterile drape should be on top of and covering any gap between the 2 fields.

Step 9

Open all supplies. Set lid on sterile drape. Remove cap from prefilled sterile saline syringe and attach to the balloon inflation port on the catheter. Open the package of antiseptic swabs or fluff cotton balls in a tray before pouring antiseptic solution over them. Ensure clamp on drainage bag is closed.

Step 10

Open lubricant and place in tray. Set tip of foley in lubricant to lubricate 1 to 2 inches of catheter tip.

Step 11

With thumb and one finger of nondominant hand, spread labia and identify meatus. Be prepared to maintain separation of labia with one hand until catheter is inserted and urine is flowing well.

Step 12

Continue to maintain separation of labia with nondominant hand Use the dominant hand to pick up an antiseptic swab or use forceps to pick up a cotton ball. Clean labial fold farthest from you, top to bottom (from above the meatus down toward the rectum), then discard the swab/cotton ball. Using a new swab/cotton ball for each stroke, clean the labial fold closest to you. Lastly clean directly over the meatus, down the middle.

Step 13

Continue to maintain separation of labia with nondominant hand. Using your dominant hand, hold the catheter 2 to 3 inches from the tip and insert slowly into the urethra. Ask the client to breathe deeply. Advance the catheter until there is a return of urine (approximately 2 to 3 inches), rotate catheter gently if slight resistance is met. Once urine drains, advance the catheter another 1 to 2 inches.

Step 14

Hold the catheter securely at the meatus with your nondominant hand. Use your dominant hand to inflate the catheter balloon. Inject the entire volume of sterile water supplied in the prefilled syringe. After the balloon is inflated, use your nondominant hand to pull gently on the catheter, checking for slight resistance.

Step 15

Dispose of used supplies according to facility policy. Wash and dry perineal area

Step 16

Secure catheter tubing to client's inner thigh using a facility approved catheter-securing device. Leave some slack in catheter to allow for leg movement.

Step 17

Secure the drainage bag below the level of the urinary bladder. Check that drainage tubing is not kinked and that movement of side rails does not interfere with the catheter or drainage bag. Place on non-movable part of the bed. Be sure tubing and drainage bag do not touch the floor.

Step 18

Perform XYZ's