Catheter CHECKLIST

4/2/24, 12:42 PM M1 : Lesson 6 : Inserting a Straight Catheter or Indwelling Catheter to a Male and Female Patient by: C.M.
by: C.M.Trinidad and Dr.H.Flore…
M1 : Lesson 6 : Inserting a Straight

Catheter or Indwelling Catheter to a
Male and Female Patient by:
C.M.Trinidad and Dr.H.Floresca
INTRODUCTION:
An indwelling catheter may be inserted for an acute episode of urinary retention or

when other strategies to manage retention are ineffective. A catheter is chosen that
minimizes urethral irritation and maximizes drainage from the bladder.
Definition: Catheterization of the bladder involves introduction of a rubber or

silicone tube through the urethra and into the bladder. It is used for the following
purposes: immediate relief of bladder distention, management of an incompetent
bladder, obtaining a sterile urine specimen, and assessment of residual urine after
voiding.
Figure A: Placement of Urinary Catheter to a Male and Female Patient
PLANNING:
Prepare the materials needed.

• Sterile gloves
• Sterile drapes
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4/2/24, 12:42 PM M1 : Lesson 6 : Inserting a Straight Catheter or Indwelling Catheter to a Male and Female Patient by: C.M.Trinidad and Dr.H.Flore…
• Lubricant KY jelly
• Antiseptic cleansing solution
• Cotton balls
• Forceps
• Pre filled 10 cc syringe with normal saline to inflate balloon of indwelling catheter
• Catheter of correct size and type of procedure (i.e., intermittent or indwelling)
• Flashlight or gooseneck lamp
• Waterproof absorbent pad
• Trash receptacle
• Hospicare bag or urinary bag
• Micropore tape 2-3inches wide
• Specimen container (as needed)
Figure B: Different types of Urinary Catheters and Parts
FIGURE C: OTHER MATERIALS NEEDED FOR

CATHETERIZATION
ASSESSMENT:
Assess status of patient:
1. When patient last voided

2. Level of awareness or developmental stage
3. Mobility and physical limitations of patient
4. Patient’s sex and age
5. Distended bladder
6. Any pathological conditions and allergies
IMPLEMENTATION:
CRITERIA RATIONALE
1.Wash your hands. Wear gloves and follow Washing your hands and taking standard
standard precautions if contact with blood or body precautions prevent the spread of infections.
fluids cannot be avoided. (Carter, 2012)
Identifying the person ensures that the
2. Identify the person using two identifiers (age and procedure is being done on the correct
date of birth), and greet him or her by name. patient or resident. Greeting the person by
name is being courteous. (Carter, 2012)
Helps the person know what to expect and
3. Explain the procedure and encourage the person
helps him understand how he can help.
to participate as appropriate.
(Carter, 2012)
4. Provide privacy by showing any visitor where

Asking visitors to leave the room, and closing
they should wait, if necessary, until you have
the door and curtain protect the person’s
completed the procedure. Close the door and the
right to privacy. (Carter, 2012)
curtain.
5. Facing patient, stand on left side of bed if right
handed. Clear bedside table and arrange
equipment.
Successful catheter insertion requires nurse
6. Place side rail on opposite side of the bed. to assume comfortable position with all
equipment easily accessible. (Perry, 2013)
7. Place waterproof pad under patient.
8. Position client. Assist to supine position with

thighs slightly abducted
9. Drape patient. Drape upper trunk with bath

blanket and cover lower extremities with bed sheets This promotes client’s safety. (Perry, 2013)
exposing only genitalia.
10. When inserting indwelling catheter, open
package containing drainage system. Place
Prevents soiling of bed linen. (Perry, 2013)
drainage bag over edge of bottom bed frame. Bring
drainage tube up between side rail and mattress.
11. Open catheterization kit according to directions,
This position relaxes abdominal and perineal
using aseptic technique. Place waste receptacle in
muscles. (Smith, 2011)
accessible place.
This avoids unnecessary exposure of body
12. Don sterile gloves. parts and maintains client’s comfort. (Perry,
2013)
13. Organize supplies on sterile field:
13.1 Open sterile package containing catheter; pour

sterile package of antiseptic solution in correct
This facilitates connection of the catheter to
compartment containing sterile cotton balls
the drainage system and provided for easy
13.2 Lubricate tip of catheter, remove specimen access. (Taylor, 2014)
container and pre-filled syringe from collection
compartment of tray and set them aside of sterile
field.
14. Nurses may want to ensure that inflatable Placement of equipment near the work site
balloon of indwelling catheter is intact by inserting increases efficiency. Sterile technique
syringe tip through valve of intake lumen and protects the patient and prevents the spread
injecting sterile fluid until balloon inflates. Then of microorganisms. (Taylor, 2014)
aspirate all fluid out of inflated lumen.
15. Apply sterile drape. Apply drape over thighs just
below penis. Pick up fenestrated sterile drape, allow This allows nurse to handle sterile supplies
it to unfold, and drape it over penis with fenestrated without contamination. (Perry, 2013)
slit resting over penis.
16.Place sterile tray and contents on sterile drape
between thighs.
It is necessary to open all supplies and
17.Determine that catheter tip is properly lubricated.
prepare for the procedure while both hands
Male 12.5-17.5 cm (5-7 inches).
are sterile. (Taylor, 2014)
Cleanse urethral meatus.
18.1 If patient is not circumcised, retract foreskin

with nondominant hand. Grasp penis at shaft just
below glans. Retract urethral meatus between
thumb and forefinger. Maintain nondominant hand This eases insertion of catheter through
in this position throughout procedure. urethral canal. (Perry, 2013)
18.2 With dominant hand, pick up cotton ball with

forceps and clean penis. Move it in circular motion
from meatus down to base of glans. Repeat
cleansing two more time using clean cotton balls
each time.
This checks integrity of balloon. Do not use

19. Pickup catheter with gloved dominant hand 7.5-
the catheter if the balloon does not inflate or
10 cm (3-4 inches) from catheter tip. Hold end of
leaks. Checking the balloon in this way may
catheter loosely coiled in palm of dominant hand.
stretch the balloon and cause increased
Place distal end of catheter in urine tray specimen.
trauma on insertion. (Perry, 2013)
The drape expands the sterile field and
20. Insert catheter protects against contamination. Use of
20.1 Lift penis to position perpendicular to client’s fenestrated drape may limit visualization and
body and apply slight traction. is considered optional by some practitioners.
(Taylor, 2014)
20.2 Ask patient to bear down as if to void and This provides easy access to supplies during
slowly insert catheter through meatus. catheter insertion. (Perry, 2013)
20.3 Advance catheter 17.5-22.5 cm (7-9 inches) in

adult and 5- 7.5 cm (2-3 inches) in young child or
until urine flows out catheter’s end. If resistance is This eases insertion of catheter through
felt, withdraw catheter and do not force it through urethral canal. (Perry, 2013)
urethra. When urine appears, advance catheter
another 5 cm (2 inches).
The hand touching the penis becomes

20.4 Lower penis and hold catheter securely in contaminated. Cleansing the area around the
nondominant hand. Place end of catheter in urine meatus and under the foreskin in the
tray receptacle. uncircumcised male patient helps prevent
infection. (Taylor, 2014)
For Female Patient
21. Cleanse urethral meatus

Moving from the meatus toward the base of
21.1 With nondominant hand, carefully retract the the penis prevents bringing organisms to
labia to fully exposed urethra meatus. Maintain meatus. (Taylor, 2014)
position of nondominant hand throughout the
procedure
21.2 With dominant hand, pick up cotton ball with

forceps and clean perineal by wiping from front to
back or from clitoris towards anus. Use new cotton
ball for each wipe along near labial fold, directly
over meatus and along labial fold.
22. Pick up catheter with gloved dominant hand 7.5-
Hold catheter near tip because it allows
10 cm (3-4 inches) from catheter tip. Hold the end
easier manipulation during insertion into
of catheter loosely coiled in the palm of the
urethral meatus and prevents distal end from
dominant hand. Place distal end of catheter in urine
striking contaminated surface.
tray specimen.
23. Insert catheter This movement straightens the urethra for
23.1 Ask patient to bear down easier insertion of catheter. (Smith, 2011)
as if to void and slowly insert catheter through Bearing down eases the passage of the
meatus. catheter through the urethra. (Taylor, 2014)
Deep breaths or slight twisting of the

23.2 Advance catheter 5-7.5 cm (2-3 inches) in
catheter bay ease the catheter past
adult and 2.5 cm (1 inch) in young child or until
resistance at sphincters. Advancing an
urine flows out catheter’s end. When urine
indwelling catheter facilitates inflation of the
appears, advance catheter up to another 5cm (2
balloon without damaging the urethra.
inches). Do not force against resistance.
(Taylor, 2014)
23.3 Release labia and hold catheter securely with This allows sterile specimen to be obtained
nondominant hand. for culture analysis. (Perry, 2013)
24. Collect urine specimen as needed: fill specimen
cup to desired level (20-30 mL) by holding the end
of catheter with the dominant hand over the cup.
With dominant hand, pinch catheter to stop urine This allows sterile specimen to be obtained
flow temporarily. Release catheter to allow for culture analysis. (Perry, 2013)
remaining urine in bladder to drain in the collection
tray. Cover the specimen cup and set aside for
labeling.
25. Allow bladder to empty full (750-1000 mL)
Retained urine may serve as reservoir for
unless institution policy restricts maximal volume of
growth of microorganisms. (Perry, 2013)
urine to drain with each catheterization.
25.1 For straight, single use catheter, pinch catheter

This causes less discomfort to the patient.
and remove slowly but smoothly when urine ceases
(Taylor, 2014)
to flow.
The balloon anchors the catheter in place in
25.2 For indwelling catheter, inflate balloon of the the bladder. Sterile water is used to inflate
indwelling catheter. the balloon as a precaution in case the
balloon ruptures. (Taylor, 2014)
25.3 While holding catheter with your thumb and
little finger of the nondominant hand at meatus,
take end of catheter and place it between first two
fingers of nondominant hand.
25.4 With free dominant hand, attach syringe to
injection port at the end of catheter.
25.5 Slowly inject total amount of solution. If client
complains of sudden pain, aspirate back solution
and advance catheter further.
25.6 After inflating the balloon fully, release Improper inflation can cause patient’s
catheter with the nondominant hand and pull it discomfort and malpositioning of catheter.
gently if there is resistance. (Taylor, 2014)
26. Attach end of catheter to the collecting tube of To facilitate drainage of urine by gravity.
drainage system. Drainage bag must be below level Raising bag on side rail will cause backflow
of bladder. of urine into bladder. (Perry, 2013)
27. Tape catheter tubing on top of thigh or lower Closed drainage system minimizes the risk
abdomen. Allow slack in catheter so movement of organisms being introduced into the
does not create tension on catheter. bladder. (Taylor, 2014)
Anchoring catheter to lower abdomen
28. Be sure that there are no obstructions or kinks
reduces pressure on urethra at junction of
in tubing. Inspect all that may lead to obstruction in
penis and scrotum, thus reducing the
the flow of the urine from the catheter to the
possibility of tissue injury at this area. (Perry,
drainage bag.
2013)
29. Remove gloves and dispose of equipment,
drapes and urine in proper receptacle.
30.Assist client to comfortable position. Wash dry
perineal area as needed.
31.Instruct patient on ways to lie in bed with
catheter. Side lying facing drainage system with
This facilitates drainage of urine and
catheter and tubing draped over thigh and side lying
prevents the backflow of urine. (Taylor, 2014)
facing away from the system, catheter and tubing
extended between legs.
It maintains comfort and security. (Perry,
32. Caution patient against pulling the catheter.
2013)
It reduces transmission of microorganisms.
33. Wash hands thoroughly.
(Perry, 2013)
EVALUATION:
Palpate bladder and ask if patient remains uncomfortable.
Determine if there is no urine leaking from catheter or tubing connections.
Record time of procedure, characteristics and amount of urine in drainage system.
Observe for signs of obstruction (e.g., decreased urine in collection bag, voiding
around the catheter, abdominal discomfort and bladder distention).
Nursing Considerations:
1. Maintain catheter patency. Place drainage tubing properly to avoid kinking or

pinching.
2. Irrigate catheter as necessary.
3. Ensure comfort and safety. Relieve bladder spasms by administering belladonna
suppositories (if ordered). Ensure adequate fluid intake and provide perineal care.
4. Prevent infection by maintaining a closed drainage system and prevent backflow of
urine by keeping drainage system below level of bladder.
5. Empty collection bag at least 8 hours.
6. Promote acidification of the urine with acid ash diet and ascorbic acid.
7. Change catheter or drainage system only when necessary.
8. For children or adolescents: they may be tempted to pull or tug on the catheter.
Children and adolescents may be more active in and out of bed, so the catheter
must be taped securely to the thigh to prevent it from being pulled out.
CENTRO ESCOLAR UNIVERSITY
Manila * Makati * Malolos
SCHOOL OF NURSING
PROCEDURE CHECKLIST
Inserting A Straight or Indwelling Catheter
NAME OF STUDENT: SCORE:

YEAR/SECTION/GROUP/NUMBER:
Rate the student's performance by checking the appropriate box using the following
criteria:
5 - Excellent (Carries out procedures efficiently, systematically and independently/Personality

trait is observed at all times)
4 - Very Satisfactory (Carries out procedures efficiently and systematically but requires minimal
guidance and supervision/Personality trait is observed at all times)
3 - Satisfactory (Carries out the procedures efficiently and systematically but requires moderate
guidance and supervision/Personality trait is observed at all times)
2 - Fair (Carries out the procedures efficiently and systematically but requires close guidance
and supervision/Personality trait is observed at all times)
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1 - Poor (Carries out the procedures inefficiently, unsystematically even under close guidance
and supervision/Personality trait is observed at all times)
0 - Not done
CRITERIA 5 4 3 2 1 0
ASSESSMENT:
1.Assess the status of the Patient
1.1 When patient last voided
1.2 Level of awareness or developmental stage
1.3 Mobility and physical limitations of patient
1.4 Patient’s sex and age
1.5 Distended bladder
1.6 Any pathological conditions and allergies
PLANNING:
1. Prepare the materals needed.
1.1 Sterile gloves
1.2 Sterile drapes
1.3 Lubricant KY jelly
1.4 Antiseptic cleansing solution
1.5 Cotton balls
1.6 Forceps
1.7 Prefilled 10 cc syringe with normal saline to inflate balloon of

indwelling catheter
1.8 Catheter of correct size and type of procedure (i.e.,

intermittent or indwelling)
1.9 Flashlight or gooseneck lamp
IMPLEMENTATION:
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1.Wash your hands. Wear gloves and follow standard precautions

if contact with blood or body fluids cannot be avoided
2. Identify the person, and greet him or her by name.
3. Explain the procedure and encourage the person to participate

as appropriate.
4. Provide privacy. Close the door and the curtain.
5. Facing patient, stand on left side of bed if right handed. Clear
bedside table and arrange equipment.
6.Place side rail on opposite side of the bed.
7.Place waterproof pad under patient.

8. Position client. Assist to supine position with thighs slightly
abducted.
9. Drape patient. Drape upper trunk with bath blanket and cover
lower extremities with bed sheets exposing only genitalia.
10. When inserting indwelling catheter, open package containing
drainage system. Place drainage bag over edge of bottom bed
frame. Bring drainage tube up between side rail and mattress.
11. Open catheterization kit according to directions, using aseptic
technique. Place waste receptacle in accessible place.
12. Don sterile gloves.

13. Organize supplies on sterile field:
13.1 Open sterile package containing
catheter; pour sterile package of antisepti solution in correct
compartment containing sterile cotton balls.
13.2 Lubricate tip of catheter, remove specimen container and

pre-filled syringe from collection compartment of tray and set them
aside of sterile field.
14. Nurses may want to ensure that inflatable balloon of indwelling
catheter is intact by inserting syringe tip through valve of intake
lumen and injecting sterile fluid until balloon inflates. Then aspirate
all fluid out of inflated lumen.
15. Apply sterile drape. Apply drape over thighs just below penis.
Pick up fenestrated sterile drape, allow it to unfold, and drape it
over penis with fenestrated slit resting over penis.
16. Place sterile tray and contents on sterile drape between thighs.
17. Determine that catheter tip is properly lubricated. Male 12.5-

17.5 cm (5-7 inches).
18. Cleanse urethral meatus.
18.1 If patient is not circumcised, retract foreskin with nondominant
hand. Grasp penis at shaft just below glans. Retract urethral
meatus between thumb and forefinger. Maintain nondominant
hand in this position throughout procedure.
18.2 With dominant hand, pick up cotton ball with forceps and
clean penis. Move it in circular motion from meatus down to base
of glans. Repeat cleansing two more time using clean cotton balls
each time.
19. Pickup catheter with gloved dominant hand 7.5-10 cm (3-4
inches) from catheter tip. Hold end of catheter loosely coiled in
palm of dominant hand. Place distal end of catheter in urine
tray specimen.
20. Insert catheter

20.1 Lift penis to position perpendicular traction.
20.2 Ask patient to bear down as if to void and slowly insert

catheter through meatus.
20.3 Advance catheter 17.5-22.5 cm (7-9 inches) in adult and 5-
7.5 cm (2-3 inches) in young child, or until urine flows out
catheter’s end. If resistance is felt, withdraw catheter and do not
force it through urethra. When urine appears, advance catheter
another 5 cm (2 inches).
20.4 Lower penis and hold catheter securely in nondominant

hand.
Place end of catheter in urine tray receptacle.
For Female Patient
21. Cleanse urethral meatus

21.1 With nondominant hand, carefully retract the labia to fully
exposed retract the labia to fully exposed urethra meatus.
Maintain position of nondominant hand throughout the procedure.
21.2 With dominant hand, pick up cotton ball with forceps and
clean perineal by wiping from front to back or from clitoris towards
anus. Use new cotton ball for each wipe along near labial fold,
directly over meatus and along labial fold
22. Pick up catheter with gloved dominant hand 7.5-10 cm (3-4
inches) from catheter tip. Hold the end of catheter loosely coiled in
the palm of the dominant hand. Place distal end of catheter in
urine tray specimen.
23. Insert catheter
23.1 Ask patient to bear down as if to void and slowly insert
catheter through meatus.
23.2 Advance catheter 5-7.5 cm (2-3inches) in adult and 2.5 cm
(1 inch) in young child or until urine flows in young child or until
urine flows out catheter’s end. When urine appears, advance
catheter up to another 5 cm (2 inches). Do not force against
resistance.
23.3 Release labia and hold catheter securely with nondominant
hand.
24. Collect urine specimen as needed: fill specimen cup to desired
level (20-30 mL) by holding the end of catheter with the dominant
hand over the cup. With dominant hand, pinch catheter to stop
urine flow temporarily. Release catheter to allow remaining urine in
bladder to drain in the collection tray. Cover the specimen cup and
set aside for labeling.
25. Allow bladder to empty full (750-1000 mL) unless institution
policy restricts maximal volume of urine to drain with each
catheterization.
25.1 For straight, single use catheter, pinch catheter and remove
slowly but smoothly when urine ceases to flow.
25.2 For indwelling catheter, inflate balloon of the indwelling

catheter.
25.3 While holding catheter with your thumb and little finger of the
nondominant hand at meatus, take end of catheter and place it
between first two fingers of nondominant hand.
25.4 With free dominant hand, attach syringe to injection port at
the end of catheter.
25.5 Slowly inject total amount of solution. If client complains of
sudden pain, aspirate back solution and advance catheter further.
25.6 After inflating the balloon fully, release catheter with the
nondominant hand and pull it gently if there is resistance.
26. Attach end of catheter to the collecting tube of drainage
system.Drainage bag must be below level of bladder.
27. Tape catheter tubing on top of thigh or lower abdomen. Allow

slack in catheter so movement does not create tension on
catheter.
28. Be sure that there are no obstructions or kinks in tubing.
Inspect all that may lead to obstruction in the flow of the urine
from the catheter to the drainage bag.
29. Remove gloves and dispose of equipment, drapes and urine in
proper receptecle.
30. Assist client to comfortable position. Wash dry perineal area as
needed.
31. Instruct patient on ways to lie in bed with catheter. Side lying
facing drainage system with catheter and tubing
draped over thigh and side lying facing away from the
system, catheter and tubing extended between legs.
32. Caution patient against pulling the catheter.
33. Wash hands thoroughly.
EVALUATION
1.Palpate bladder and ask if patient remains uncomfortable.

2. Determine if there is no urine leaking from catheter or tubing
connections.
3.Record time of procedure, characteristics and amount of urine in
drainage system.
4. Observe for signs of obstruction (e.g., decreased urine in
collection bag, voiding around the catheter, abdominal
discomfort and bladder distention).
Total Score:
Comments/Suggestions:
Computation: Total Score divided by (number of items) x 20 (factor) = _________________
*Total points shall be transmuted using the table for 100 pts. Passing cut-off point is 65.
Equivalent Numeric Grade: _______________
Interpretation: __________________________
EVALUATOR: CONFORME:
DATE:
_______________________________________________
___________________________________________ ___________________
CLINICAL INSTRUCTOR'S NAME & SIGNATURE STUDENT'S
SIGNATURE

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4/2/24, 12:42 PM M1 : Lesson 6 : Inserting a Straight Catheter or Indwelling Catheter to a Male and Female Patient by: C.M.

by: C.M.Trinidad and Dr.H.Flore…

M1 : Lesson 6 : Inserting a Straight

An indwelling catheter may be inserted for an acute episode of urinary retention or

Definition: Catheterization of the bladder involves introduction of a rubber or

Figure A: Placement of Urinary Catheter to a Male and Female Patient

Prepare the materials needed.

Figure B: Different types of Urinary Catheters and Parts

FIGURE C: OTHER MATERIALS NEEDED FOR

Assess status of patient:

1. When patient last voided

4. Provide privacy by showing any visitor where

7. Place waterproof pad under patient.

8. Position client. Assist to supine position with

9. Drape patient. Drape upper trunk with bath

13. Organize supplies on sterile field:

13.1 Open sterile package containing catheter; pour

Cleanse urethral meatus.

18.1 If patient is not circumcised, retract foreskin

18.2 With dominant hand, pick up cotton ball with

This checks integrity of balloon. Do not use

20.3 Advance catheter 17.5-22.5 cm (7-9 inches) in

The hand touching the penis becomes

For Female Patient

21. Cleanse urethral meatus

21.2 With dominant hand, pick up cotton ball with

Deep breaths or slight twisting of the

25.1 For straight, single use catheter, pinch catheter

Palpate bladder and ask if patient remains uncomfortable.

Determine if there is no urine leaking from catheter or tubing connections.

Record time of procedure, characteristics and amount of urine in drainage system.

1. Maintain catheter patency. Place drainage tubing properly to avoid kinking or

CENTRO ESCOLAR UNIVERSITY

Manila * Makati * Malolos

Inserting A Straight or Indwelling Catheter

NAME OF STUDENT: SCORE:

5 - Excellent (Carries out procedures efficiently, systematically and independently/Personality

1.Assess the status of the Patient

1.1 When patient last voided

1.2 Level of awareness or developmental stage

1.3 Mobility and physical limitations of patient

1.4 Patient’s sex and age

1.5 Distended bladder

1.6 Any pathological conditions and allergies

1. Prepare the materals needed.

1.1 Sterile gloves

1.2 Sterile drapes

1.3 Lubricant KY jelly

1.4 Antiseptic cleansing solution

1.5 Cotton balls

1.7 Prefilled 10 cc syringe with normal saline to inflate balloon of

1.8 Catheter of correct size and type of procedure (i.e.,

1.9 Flashlight or gooseneck lamp

1.Wash your hands. Wear gloves and follow standard precautions

3. Explain the procedure and encourage the person to participate

7.Place waterproof pad under patient.

12. Don sterile gloves.

13.2 Lubricate tip of catheter, remove specimen container and

17. Determine that catheter tip is properly lubricated. Male 12.5-