Introduction

A urinary catheter is a tube placed in the bladder to drain the urine for a variety of reasons such as incontinence, pressure sore-care or retention of urine. This maybe permanent, temporary or intermittent.

General Tips

• Always record the amount of urine in the bag.
• Check that the urine is flowing into the bag.
• Make sure the person drinks sufficient fluids to promote a good urinary output.
• The urine bag should always be below the level of the bladder. This will prevent urine from flowing back into the bladder from the tubing and urine bag. Backflow of urine can cause an infection.
• Check that the tubing and bag are in good condition.
• Never pull the catheter or tubing.
• Any kinks or obstruction in the tube should be removed. Make sure the patient is not sitting or lying on top of the tubing.
• Check the skin around the catheter for signs of irritation, discomfort or infection. The vagina or the tip of the penis may become swollen, red and sore.
• Do not use powder around the catheter entry site.
• The urine bag should be emptied its full upto ¾ of bag or at least every eight hours.

Catheter Hygiene

• Before you start, tell the patient what you are going to do and why. This is important for everyone, especially if the person is confused, has memory problems as in Alzheimer’s disease or dementia.
• If you can, assist the catheterized person with their hygiene, rather than doing it yourself. It is important to try to help the person / patient keep their skills rather than just take over from them.
• Wash around the catheter entry site with soap and water twice each day.
• Always wash the site after a bowel movement.

Emptying The Urine Bag:

The following are steps to be used when emptying the bag:

• Place a large plastic or metal container on the floor next to you, or you may empty the urine into the toilet.
• Wash your hands with soap and water.
• Remove the drain spout from its sleeve at the bottom of the urine bag.
• Let the urine flow out of the urine bag into the container or toilet. Do not let the drainage tube touch anything.
• When the bag is empty, clean the end of the drain spout with water and put the drain spout into its sleeve at the bottom of the urine bag.
• Wash your hands with soap and water.
• Write down how much urine was in the bag.

Cleaning The Urine Bag:

• Get a new or cleaned urine bag with tubing.
• Wash your hands with soap and water.
• Put a clamp on the catheter tubing near the connection to the urine bag tube. Unhook the old bag and hook the catheter to the new bag. Unclamp the catheter tubing.
• Rinse the old bag with warm water.
• Empty and rinse the bag. Hang it upside down and let it air dry.
• When the bag is dry, store it in a clean plastic bag until you are ready to use it again.

Handling Cathether Problems

If the catheter is not draining:

• Check for kinks. See if the urine tubing is twisted or bent.
• See if you are lying on the catheter or tubing.
• Make sure the urine bag is below the level of your bladder (waist level).
• Change your position and separate your thighs (upper legs).
• Irrigate (flush) the catheter if you have been taught how to irrigate catheters.

If your catheter comes out or is leaking:

• Place a towel or waterproof pad under you to protect your furniture if your catheter leaks or comes out. Do not try to put the catheter back in unless you have been taught how to insert a Foley catheter.
• Look for these signs of leaking: The level of urine in the bag has stopped, rising and no urine has drained from the catheter in 6 to 8 hours.
• Your bed or clothes are wet with urine

Catheter Complications

Seek medical help if you see any of the following signs and symptoms:

• The urine has a strong smell or becomes thick and/or cloudy.
• The person develops a fever, sweats or chills.
• There is swelling around the catheter.
• The catheter stops draining or there is very little urine despite adequate fluid intake.
• There is leakage of large amounts of urine around the catheter.
• Bleeding into or around the catheter.