Nursing procedure for catheter insertion

Vaculation Definition
It is the insertion of a sterile catheter through the urethra into the bladder.

Most common indications

 * Patients with urinary retention.
 * To determine the volume of residual urine in the bladder.
 * In patients with urinary incontinence.
 * To collect sterile urine for laboratory examination.
 * To flush the bladder.
 * For the application of drugs into the bladder.
 * For monitoring diuresis.

Division of vasculature

 * Disposable.
 * Permanent.



Types of urinary catheters

 *  Nelaton's (Robinson's in Anglo-Saxon literature)

The catheter is straight, used for one-time vascularization of women.


 * Tiemann's

Tiemann's catheter differs from Nelaton's by a curved, conically elongated beak at the end. It is used for one-time catheterization of men.


 * Folley permanent catheter

The catheter, like other tubes, is made of flexible material, it differs only in the fixation balloon at the end of the catheter and the mouth of the tube is adapted to a collection system.

Urinary catheters come in various sizes and diameters. It is most often used for numbering the Charrier scale, which is the same as the French numbering (it is said that the designation French was used by Americans when they failed to pronounce the French name Charrier). The size number is indicated on the catheter package, for permanent catheters, the package also indicates the recommended amount of liquid, which is used to fill the fixation balloon. The maximum expiration of a permanent urethra after insertion is 30 days.

Coiling Aids
Sterile urinary catheter according to the doctor's office, sterile gloves, sterile tampons and squares, anesthetic gel, emitting dish, pulp squares, tweezers. In the case of a permanent urethra, in addition, a syringe with a sterile solution is used to fill the fixation balloon. Collection bag, disinfection.

In a woman
The procedure is performed by a nurse or midwife, who is responsible for sterile insertion and gentle handling. We will ensure the woman's privacy and explain the procedure itself. We educate the patient about the necessity and importance of hygiene in the genital area. We wash our hands, prepare sterile tools for the patient's bed so that they are easily accessible and the sterile gloves are not sterilized. We place the patient in a supine position, with the limbs bent slightly apart at the knees and hips. We will prepare a base bowl or emission bowl for the woman's parents. Moisten the tampons with disinfectant and put on sterile gloves. With the non-dominant hand, we move the labia majora apart, using the thumb and forefinger. We disinfect the labia minora on each side with a tampon. We always proceed from the mons pubis to the anus. We disinfect the middle part of the urethra with the last tampon. The hand that held the labia majora became unsterile. With sterile hands, remove the tube from the already opened bag. We hold it like this, about 5 cm from the tip between the index finger and the thumb. We hold the end of the tube above the emission bowl, where the urine will be discharged. If we need a urine sample, we collect it during the outflow into a sterile marked test tube. Carefully remove the catheter and place it in the emitting dish. We wipe the birth canal with a tissue, remove the emitting bowl and the base bowl, cover the woman. We communicate with the patient throughout the procedure and inform her about the progress of the procedure. At the end, it is important to show appreciation for the cooperation.

In a man
In men, the catheter is inserted by a doctor or a specialist nurse who informs him about the procedure. The performance must be performed gently and sterile. The nurse prepares the tools for the man's vasectomy and assists the doctor during the procedure. The patient is placed in the lithotomy position. The doctor will put on sterile gloves. The nurse hands the doctor sterile tampons soaked in a disinfectant solution. The doctor disinfects the external opening of the urethra with tampons. With the help of tweezers, the doctor inserts the tube into the urethra.

https://www.youtube.com/watch?v=x2a-s38rNns

Complications of vascularization

 * Perforation of the lower urinary tract.
 * Uroinfection.
 * Paraphimosis.
 * Urethra sphincter injury.

Related Articles

 * Bladder catheterization (pediatrics)