Bolded Skills Check Off

Female urinary catheterization: Perineal cleansing procedure

With forceps, pick up cotton ball/swab sticks saturated with antiseptic solution and clean perineal area. The order of cleaning is front toback from clitoris toward anus; wipe along the far labial fold, then the near labial fold, and then directly over center of urethral meatus. Discard cotton ball or swab stick after each wipe. (You will use 3 cotton balls or swab sticks for this, becareful not to contaminate your sterile field as youdiscard the used cotton ball/swab stick)

Female urinary catheterization: Catheter lubrication distance

Lubricate $2.5\text{ to }5\,\text{cm}$ ($1\text{--}2\,\text{inches}$) of catheter for female clients

Female Insertion of Catheter Procedure

Insert the tip of catheter into urethra. Advance the catheter until there is a return of urine (approximately 2-3 inches {4.8-7.2cm}). Once urine drains, advance the catheter another 2-3 inches (4.8-7.2 cm). Do not force the catheter through the urethra into the bladder. Ask patient to breathe deeply, and rotate the catheter gently if slight resistance is met as the catheter reaches the external sphincter.

Female Observation of the Urine (Not Bold)

Observe character and amount of urine in drainage system. If more than 800 ml of urine return is noted upon catheter placement, clamp the catheter tubing for 10 minutes, then unclamp. Determine that no urine is leaking from catheter or tubing connections.

Documentation

Record and report catheterization, characteristics and amount of urine, specimen collection (if performed), and patient’s response to procedure and teaching concepts. Initiate intake and output records. Report

absence of urine immediately.

Male urinary catheterization: Penis cleansing procedure

With forceps, pick up cotton ball/swab stick saturated with antiseptic solution and clean penis. Move cotton ball/swab stick in circular motion from urethral meatus down to base of glans. Repeat cleansing two more times. Discard cotton ball or swab stick after eachwipe. (You will use 3 cotton balls or swabsticks for this. Be careful not to contaminateyour sterile field as you discard the used cotton ball/swab stick)

Male urinary catheterization: Lubricant instillation

Use dominant hand to pick up the opened lubricant syringe. Gently insert the tip of the syringe with the lubricant into the urethra andinstill the 10 ml of lubricant.

Male urinary catheterization: Positioning and insertion technique

Lift patient’s penis to positionperpendicular to client’s body and apply light traction. Ask patient to take deep breaths. Advance the catheter through urethral meatus to the bifurcation or “Y” level of the ports. Do not force. If catheter resists entry, ask the patient to breathe deeply and rotatethe catheter slightly.

Wound Care:Beginning Part

Provide privacy. Drape the patient toexpose only the wound site.

Wound care: Assessment protocol

Observe color, odor, character, andamount of drainage on dressing. Dispose of soiled dressing in trash can. ** Inspect wound for color, character of drainage, presence of sutures or staples, presence of drains. ** Report any brisk, bright red bleeding or evidence of wound dehiscence or evisceration

Wound care: Moist gauze preparation

Prepare 4 x4 gauze as a fine mesh layer. Gauze should be moist, but without solution dripping

Wound care: Moist gauze application and packing

Apply moist fine mesh gauze as a single layer directly onto wound surface. If wound is deep, gently pack gauze into wound with cotton tipped applicators. Do not touch the outer edges of the skin with packing material