Female Catheterization Procedure

The purpose of catheterization is simply to assist in diagnosis and treatment, and of course it also serves to collect urine samples from patients. Catheterization is generally a technique in which a catheter is inserted into the patient's bladder to drain urine from it. We all know that women and men have very different body structures, so what are the steps for female catheterization?

Operation process

1. Bring the supplies to the bedside and explain the purpose of catheterization to the patient to gain cooperation.

2. For patients who can take care of themselves, ask them to clean their vulva. For those who cannot get up, the nurse will help them clean it.

3. The operator stands on the right side of the patient. The patient lies on his back with his hips and knees flexed and his legs slightly spread outward. The contralateral trouser leg is taken off and covered on the proximal leg. The contralateral thigh is covered with a blanket to expose the perineum.

4. Place a small rubber sheet and treatment towel under the patient's buttocks, place the curved tray near the perineum, place the dressing bowl and curved tray between the patient's legs, wrap a sterile gauze around the left thumb and index finger in an "8" shape, hold the hemostatic forceps in the right hand, and use a 0.1% Sanisol cotton ball to scrub the vulva (mons pubis and labia majora), then use the left thumb and index finger to separate the labia majora, scrub the labia minora and urethral opening from outside to inside and from top to bottom. Each cotton ball can only be used once. When scrubbing the urethral opening, gently rotate it downward and scrub it twice in total. The second time, use the cotton ball to scrub down to the anus, place the dirty cotton ball in the curved tray, remove the gauze from the left finger and place it in the dressing bowl, remove the dressing bowl, and place the curved tray at the end of the bed.

6. Take a curved tray and place it next to the patient's left drape opening. Lubricate the front end of the catheter with a paraffin oil cotton ball and place it in the curved tray next to the drape opening. Use your left hand to separate and fix the labia minora. Use your right hand to hold the Sanisol cotton ball with hemostatic forceps and disinfect the urethral opening from top to bottom and from inside to outside (gently rotate the urethral opening to disinfect it and then wipe downwards, twice in total) and the labia minora. Each cotton ball can only be used once. After cleaning, throw the hemostat into the dirty tray.

7. Use another hemostatic forceps to hold the catheter, aim it at the urethral opening and insert it into the urethra about 4-6 cm. When urine flows out, insert it about 1 cm further. Release your left hand, fix the catheter, and direct the urine into the sterile tray.

8. If urine culture is required, use a sterile specimen bottle and cover the bottle cap.

9. After catheterization, pull out the catheter, take off the gloves, put them in the curved tray, remove the towel, wipe the vulva, and help the patient put on pants. Make the bed, clean up the belongings, make records and then send the specimens for testing.

method

1. The patient lies on his back with his knees bent and legs abducted, and an oilcloth or a medium sheet placed under his buttocks. The patient should first clean the vulva with soapy water; male patients should turn back the foreskin for cleaning.

2. Use 2% mercurochrome, 0.1% chlorhexidine or 0.1% chlorhexidine solution to disinfect the urethral opening and vulva in a circular motion from the inside to the outside. Then cover the vulva with a sterile drape. For men, wrap the penis with a sterile drape to expose the urethral opening.

3. The operator wears sterile gloves and stands on the right side of the patient. He holds the penis with the thumb and index finger of his left hand. For females, separate the labia minora to expose the urethral opening. With the right hand, the operator slowly inserts the catheter coated with sterile lubricant into the urethra. The outer end of the catheter is clamped with hemostatic forceps and its opening is placed in a sterilized curved tray. For men, the insertion should be about 15-20 cm, and for women, about 6-8 cm. Loosen the hemostatic forceps and the urine will flow out.

4. If bacterial culture is required, collect midstream urine in a sterile test tube for examination.

5. After the operation, clamp the catheter and then slowly remove it to prevent urine in the tube from leaking out and contaminating clothes. If indwelling catheterization is required, fix the catheter with tape to prevent it from falling out, clamp the outer end with hemostatic forceps, and wrap the tube opening with sterile gauze to prevent urine from escaping and contamination; or connect a sterile plastic bag for urine retention and hang it on the side of the bed.

1. Strictly follow aseptic techniques to prevent urinary tract infection.

2. Insert the catheter gently to avoid damaging the urethral mucosa. If there is a sense of obstruction during insertion (do not insert it roughly), change the direction (or withdraw 2-3cm slightly, inject paraffin oil into the catheter to lubricate the urethra), and then insert it another 2cm when urine flows out. Do not insert it too deep or too shallow, and especially avoid repeatedly pulling out the catheter. (Although the guide wire can be inserted quickly and forcefully, it is most likely to damage the urethral mucosa, so it can be withdrawn before; paraffin oil must be repeatedly applied to the catheter twice)

3. The thickness of the catheter should be appropriate. For children or those suspected of urethral stenosis, the catheter should be thin.

4. For those with an overfull bladder, urination should be slow to avoid sudden decompression causing bleeding or fainting.

For patients with highly distended bladders and extreme weakness, the first catheterization volume should not exceed 1000ml to prevent large amounts of urination, which may lead to a sudden decrease in intra-abdominal pressure and retention of a large amount of blood in the abdominal blood vessels, causing a drop in blood pressure and collapse. It may also cause sudden decompression of the bladder, leading to rapid congestion of the bladder mucosa and causing hematuria.

5. When measuring residual urine, ask the patient to urinate on his own first and then catheterize. The residual urine volume is generally 5-10 ml. If it exceeds 100 ml, a urethral catheter should be placed.

6. When indwelling catheterization is in place, the fixation of the catheter should be checked regularly to see if it has fallen out. If necessary, the bladder should be flushed once a day with sterile liquid. The catheter should be replaced every 5-7 days, and the urethra should be relaxed for several hours before reinserting.

7. For patients with overfilled bladder, the catheterization speed should not be too fast, otherwise it may cause shock or bladder bleeding. At this time, urine should be released slowly in multiple times, about 150-200ml each time, repeatedly, and gradually empty the bladder.