Care of the bladder catheterized patient

Set of activities performed by the nurse to maintain bladder catheter patency and prevent infection.

Objectives:

– Maintain bladder catheter patency. – Decrease the risk of bladder catheter infection.

Equipment:

– See genital hygiene equipment. – See bladder lavage equipment.

– Material: – See genital hygiene procedure material. – See bladder wash procedure material. – Antiseptic solution. – 1 syringe of 50 ml. – Physiological saline solution. – Nursing records

Procedure:

– Perform hand washing. – Prepare material. – Preserve the patient’s privacy. – Inform the patient of the procedure. – Ask the patient and family to cooperate. – Put on non-sterile gloves.

– Monitor signs and symptoms of urinary tract infections (increased temperature, suprapubic flank pain, cloudy or foul-smelling urine, hematuria). – Perform genital hygiene daily and when necessary. – Wash catheter externally with soap and water at least twice a day. – Check the permeability of the catheter every shift. – Perform bladder lavage in case of catheter obstruction, introducing 30-50 c.c. of physiological saline solution. – Aspirate gently or connect to bag to check patency. – Change bag every 7-14 days and whenever the tap is obstructed. – Change catheter every 20-25 days if latex and every 8 weeks if silicone. – Keep the diuresis bag below the patient’s level. Clamp the system if the bag is to be raised above the level of the patient’s body. – Leave the patient in a comfortable position. – Collect the material. – Remove gloves. – Perform hand washing. – Record in nursing documentation the procedure performed, reason, date and time, incidences and patient response.

Observations:

– Avoid probe decubitus (in the genitals or areas where the probe or the system rubs). – Avoid unnecessary probe disconnections. – Use closed systems. – If it is necessary to clamp the catheter, do it through the drainage tube. – Observe for hematuria or pain. – Avoid kinking or twisting of the catheter. – If there are signs and symptoms of urinary tract infection, take a urine culture.