URINARY CATHERTERIZATION

Sometimes a person is unable to urinate using a toilet, bedpan, urinal, or bedside commode, due to disabilityor illness. In these situations, a urinary catheter is used. A catheter is a tube that is inserted into the body for the purpose of administering or removing
fluids. A urinary catheter is inserted into the bladder through the urethra (or through an incision made in the abdominal wall) to allow the urine in the bladder to drain out. A urinary catheter is used in many different situations:
■ A urinary catheter may be inserted to drain the bladder before or during a surgical procedure, during recovery from a serious illness or injury, or to collect urine for testing.
■ A urinary catheter may be used for a person who is incontinent of urine, if the person has wounds or pressure ulcers that would be made worse by contact with urine.
■ A urinary catheter is necessary when a person is unable to urinate because of an obstruction in the urethra.
Usually, inserting a urinary catheter is beyond the scope of practice for a nursing assistant, although in some facilities, nursing assistants are provided with additional training that allows them to catheterize residents or patients. Inserting a catheter is a procedure that requires sterile technique because it involves putting a foreign object (that is, the catheter) into a person’s body.
If sterile technique is not used, the catheter can introduce infection-causing bacteria into the bladder. Regardlessof whether or not you are trained to actually insert urinary catheters, caring for people who have urinary catheters in place will almost certainly be a part of your daily duties.

Types of Urinary Catheters
You will see many different types of urinary catheters in use.

Straight Catheters

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A straight catheter, also known as a Robinson, Rob-Nel, or Red Rubber catheter, is used when the catheter is to be inserted and removed immediately. The catheter is introduced into the bladder, the urine is allowed to drain out, and the catheter is removed.
This type of catheterization may be used to obtain a sterile urine specimen from a woman, before or after surgery, after a vaginal delivery, or when a person needs to empty his bladder but cannot as a result of pain or swelling that is temporary. New guidelines
issued by the CDC state that urinary catheters should not be used to obtain urine samples from a person who is able to void voluntarily because of the increased risk of infection.

Indwelling Catheters

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An indwelling catheter, also known as a retention or Foley catheter, is left inside the bladder to provide continuous urine drainage. An indwelling catheter has a soft balloon that is inflated inside the bladder to keep the catheter from sliding out of the urethra. Urine collects in a drainage bag, which is attached to the indwelling catheter by a length of tubing.An indwelling catheter may have two lumens or three lumens. A double-lumen indwelling catheter has two lumens. One lumen, which connects to the catheter tubing, is for urine drainage. The other is used to inflate the balloon that holds the catheter in place. A triple-lumen indwelling catheter has three
lumens.  The extra lumen is used to flush the bladder with irrigation fluid. Regular flushing of the bladder with irrigation fluid helps to keep blood clots from forming inside the bladder. This is important in certain situations, such as when a man has just had prostate
surgery.

Suprapubic Catheters

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A suprapubic catheter is a type of indwelling catheter.The suprapubic catheter is inserted into the bladder through a surgical incision made in the abdominal wall, right above the pubic bone. This type of catheter is most often used for people with blocked urethra, and for men. Men typically are notable to use an indwelling urinary catheter that is inserted through the urethra for long periods of time
due to the anatomy of the male urethra. While a woman’s urethra is straight and only about 2 inches long, a man’s urethra is curved in an “S” shape and is about 6 inches long. In men, the pressure of the indwelling catheter can cause erosion of the mucous membrane that lines the urethra in the curved areas

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