Urinary catheterization

• URINARY CATHETERIZATION

  → Is the introduction of the catheter thru the urethra into the urinary bladder
• infection

  → Patient with lower immune system
• Infection

  → Flashing of microorganisms in Urethra
• Trauma

  → Male clients have longer urethra
• Urethra is normally curve. Elevate the penis to

  position that is perpendicular to the body
• Catheter

  → Commonly made for rubber or plastic although they may be made form latex, silicon or polyvinyl chloride (PVC)
• Straight Robinson

  → single lumen, small eye opening in insertion pit.

  → Used to obtain sterile urine specimen
• Foley/ Retention/ Indwelling

  → Most common.

  → Double lumen.

  → Larger lumen drains urine.

  → Smaller lumen used to inflate the balloon with

  sterile water (10cc usual)

  → Balloon is indicated with catheter along with

  diameter.

  → 10ml sterile water
• Three Way Folley Catheter

  → Used when patients need consistent bladder urination.

  → Irrigation is needed to manage the blood clot in the bladder.

  → First lumen is the third channel (irrigation). Second is for urine. Balloon channel
• Coude Catheter

  → Straight catheter used for elderly patient have hypertrophied prostate.

  → Has tapered curve tip
• Catheter sizes for children

  → #8 or #10
• Catheter sizes for adult

  → Fr #14, 16, 18
• Plastic Catheter- For short duration (1 week or less)
• Rubber Catheter- for 2-3 weeks duration of use.
• Silicone Catheter- for long-term use (2-3 months)
• Polyvinyl Chloride- for 4-6 weeks use, soften at body temperature.
• Adults- 10 ml balloon to facilitate optimal urine drainage
• 30 ml balloon is commonly used to achieve hemostasis of the prostatic area following a prostatectomy
• Children – use 3 ml balloon
• Gloves Drapes to protect the bed & to provide a sterile field (fenestrated – having a window like opening)
• majora & minora -anteroposterior direction
• urinary meatus – from above toward vagina (female) - circular motion around glans (male)
• Enema

  → Solution introduced into the rectum and large intestine
• Enema

  → It distends large intestine and irritates the intestinal mucosa thereby increasing peristalsis and the excretion of feces and flatus.
• CLEANSING ENEMA

  → STIMULATES PERISTALSIS BY IRRITATING THE RECTUM AND COLON OR BY DISTENDING THE INTESTINE WITH THE VOLUME OF FLUID INTRODUCED
• HIGH CLEANSING ENEMA GIVEN TO CLEAN AS MUCH OF THE COLON AS

  POSSIBLE
• LOW CLEANSING ENEMA USED TO

  CLEAN THE RECTUM AND SIGMOID COLON ONLY
• CARMINATIVE ENEMA

  → Given primarily to expel flatus
• RETENTION ENEMA

  → INTRODUCES OIL OR MEDICATION INTO THE RECTUM AND SIGMOID COLON
• Types of retention enema:

  • ANTIBIOTIC ENEMA

  • ANTHELMINTIC ENEMA

  • NUTRITIVE ENEMA
• RETURN FLOW

  → SOMETIMES REFFERED TO AS HARRISH FLUSH OR COLONIC IRRIGATION, IS USED TO EXPEL FLATUS
• Commercially Prepared:

  90-120 ml of a hypertonic solution such as sodium phosphate
• Saline:

  500-1000 ml of normal saline
• Tap water:

  500-1000 ml of tap water
• Soap:

  3-5 ml of white bland soap to 1000 ml of water
• Oil:

  90-120 ml of oil commercially prepared: mineral, olive or cottonseed
• Administering enema for CHILDREN LESS THAN 18 MOS:

  50–200ML
• Administering enema for CHILDREN 18 MOS. TO 5 Y/O:

  200 -300 ML
• Administering enema for CHILDREN 5 – 12 Y/O:

  300-500 ML
• Administering enema for adolescent:

  500- 750 ML