 Urine clears the body of waste material  -aids in the balance of electrolytes  -conditions that interfere with urinary  drainage may create a health crisis  -important to re-establish urine flow as  soon as possible to prevent build up of  toxins in the bloodstream  -urinary catheters are used to maintain urine  flow, divert urine flow to facilitate healing  post-op and dilate or prevent narrowing of  some portion of the urinary tract 

 Catheters  - may be used for intermittent or continuous  drainage  -may be introduced into the bladder, ureter, or  kidney  -type and size determined by location and cause  of the urinary tract problem  -measured by the French system  -Urethral catheters range in size from 12Fr-24Fr  -Ureteral catheter: 4FR-6Fr and always inserted by  the physician

 Types of Catheters  -Coude’ -tapered tip, easier to insert when  enlarged prostate is suspected  -Foley -simple uretheral catheter, balloon near the  tip to anchor  -Malecot, Pezzer, or Mushroom –used to drain  urine from the renal pelvis of the kidney, can also  be used for suprapubic drainage  -Robinson –a straight catheter with multiple openings in the  tip to facilitate intermittent drainage  -Ureteral –long, slender catheter passed into the  ureter  -Whistle-tip –has a slanted, larger opening at its tip  to be used if blood is in the urine

 Coude’ catheter  Robinson catheter  Ureteral catheter

 -Cystostomy, Vesicostomy or suprapubic  catheter –inserted by the physician through  the abdominal wall above the symphysis  pubis; used to divert urine flow from the  urethra, is connected to a sterile closed  drainage system.  -External (Texas or condom0 catheter –  -drainage system connected to the penis  -noninvasive  -removed daily for cleaning and skin  inspection 

 Nursing Interventions and Patient Teaching  -Principle to prevent and detect infection and  trauma  Aseptic technique for insertion  Record I & O  Adequate hydration  Do not open drainage system after it is in place  except to irrigate the catheter per MD order.  Catheter care twice a day, inspect insertion site  Check system daily for leaks  Avoid placing the drainage bag above the level  of the bladder!

 -Prevent tension on the system of backflow  wile transferring patient  -Ambulate the patient or turn and  reposition every 2 hours  -Observe characteristics of the urine  -Sterile specimen collected through the  drain port  -Report and record assessment findings

 Self-Catherization  -Uses for spinal cord injury or other  neurological disorders  -Promotes independent function of the  patient.  -Instruct about surgical asepsis, however  at home there is less risk of cross-  contamination and patient will probably  use a modified clean technique  -Instruct in symptoms of UTIs

 Bladder Training  -Developing the use of the muscles of the  perineum to improve voluntary control over  voiding  -In preparation for removal of a urethral  catheter, the p[physician may order a clamp/  unclamp schedule to improve bladder tone  -Kegal exercises –tightening the muscles of the  perineal floor  -Voiding schedule may be established