Urinary Catheterization: Insertion and Removal of Indwelling Catheter



Urinary Catheterization: Insertion and Removal of Indwelling Catheter









CHILD AND FAMILY ASSESSMENT AND PREPARATION



  • Assess the cognitive level, readiness, and ability to process information by the child and family. The readiness to learn and process information may be impaired as a result of age, stress, or anxiety.


  • Assess the child for signs and symptoms of urinary tract or bladder infection, including fever, inability to
    void, burning on urination, feeling of fullness, bladder spasms, foul-smelling urine, redness or irritation of urethral opening, urethral discharge, crying without consolation, or discomfort.


  • Assess the child for signs and symptoms of a distended bladder or residual urine, for which bladder emptying would be required.








    TABLE 107-1 Selection of Urinary Catheter




















    Age (year)


    Recommended Catheter Size (French/Charriere)a


    0-2


    6 F


    2-5


    6-8 F


    5-10


    8-10 F


    10-16


    10-12 F


    a Feeding tubes are more prone to knotting and should not be used. Because of its two internal lumens, the balloon catheter must have a larger external diameter than might otherwise be necessary for adequate drainage of urine. In small-sized balloon catheters, the stylet provided for insertion may increase the risk for false passage or bladder perforation. If balloon catheters are used, they should be made of nonlatex 100% silicone or latex catheters made from silver, silicone elastomer, hydrophilic polymer, or coated with Teflon, which reduces irritation and inflammation of the urethral mucosa.



  • Identify and discuss the risks and benefits of placing an indwelling catheter.


  • Determine whether the child has latex allergies or previous catheter complications.


  • Reinforce the need for catheter placement, as appropriate, to both the child and the family.


  • Provide the opportunity to ask questions and alleviate fears.


  • Explain the procedure, as appropriate, to both the child and the family.

    imageKidKare Reassure the toddler and older child that the catheter is flexible and will feel like a noodle and will produce a feeling of pressure and a desire to urinate.


  • Provide instruction on pelvic muscle relaxation when ever possible. To relax pelvic and periurethral muscles, teach the child to blow a pinwheel and to press the hips against the bed or examination table during the catheterization. Next, teach the child to contract and relax the pelvic muscles and to repeat this relaxation procedure during catheter insertion.

Jul 9, 2020 | Posted by in NURSING | Comments Off on Urinary Catheterization: Insertion and Removal of Indwelling Catheter

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