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Andrew Pollack-Gray

Nursing Notes

Urinary Catheter Care

3 min read

Patient Needs

Urinary catheters are devices used to drain urine from the bladder for specific clinical indications, such as urinary retention or certain situations requiring accurate urine output measurement. Indwelling catheters should not be used routinely to manage urinary incontinence.

Types

  • Straight catheter: Inserted temporarily to drain the bladder and then removed.
  • Indwelling urethral catheter: Remains in the bladder, typically secured by an inflated balloon.
  • Suprapubic catheter: Enters the bladder through an opening in the lower abdomen.
    Catheter insertion and removal are not routine CNA tasks.

What Should I Assess?

Observe for:

  • Kinks, pulling, or tension on tubing.
  • Collection bag position.
  • Urine amount, color, and unusual appearance.
  • Leakage around tubing or collection devices.
  • Discomfort, pain, or changes in the resident’s condition.
  • Redness, drainage, or skin irritation near the catheter.

How Do I Provide Care?

Routine Catheter Care

  1. Explain care and provide privacy.
  2. Perform hand hygiene and apply appropriate PPE.
  3. Position the resident comfortably.
  4. Perform gentle routine hygiene as trained and directed.
  5. Avoid pulling on the catheter.
  6. Keep the catheter secured according to the care plan.
  7. Maintain an unobstructed drainage pathway.
  8. Return the resident to a comfortable, safe position.
  9. Perform hand hygiene and document care as required.

Drainage Bag Safety

  • Keep the drainage bag below the level of the bladder.
  • Do not place the bag on the floor.
  • Keep tubing free of kinks.
  • Avoid pulling or disconnecting the system.
  • Empty the bag using the approved method when assigned.
  • Use clean, resident-specific measuring equipment as required.
  • Avoid contaminating the drainage spout.

Measuring Output

  • Measure urine using the designated graduated container.
  • Record the volume in milliliters (mL).
  • Document according to the facility’s intake-and-output schedule.
  • Report unexpected decreases, absence of output, or unusual findings.

Safety & Precautions

  • Maintain a closed drainage system.
  • Do not disconnect the catheter and drainage bag merely for convenience.
  • Routine antiseptic cleansing is not recommended for preventing catheter-associated urinary tract infections.
  • Routine hygiene is appropriate.
  • Bag changes, catheter replacement, and irrigation follow clinical indications and authorized procedures.
  • Changing between a leg bag and a larger collection bag requires specific training and facility authorization.

Maintaining a Closed Drainage System

  • Avoid unnecessary disconnections between the catheter and drainage tubing.
  • If the system becomes disconnected, contaminated, or damaged, notify the nurse; do not independently replace the catheter or drainage system.
  • When emptying the bag, use a clean, resident-specific container and avoid touching the drainage spout to the container.
  • Keep the drainage bag below bladder level and off the floor.
  • Do not obtain urine culture specimens directly from a drainage bag; sampling requirements depend on the ordered test and authorized personnel.
  • Routine catheter or drainage-bag replacement at fixed intervals is not recommended solely to prevent infection.
  • Follow routine hygiene practices rather than applying antiseptics to the urethral area solely to prevent catheter-associated infection.

What Should I Report?

  • Catheter-related pain or pulling.
  • New bleeding or concerning drainage.
  • Leakage, obstruction, or absent output.
  • Fever or other possible signs of infection.
  • Broken or disconnected drainage equipment.
  • Unusual changes in urine appearance or amount.

Sources

Flashcards

Where must a urine drainage bag be positioned?03-application / patient-care
Answer

Below bladder level and off the floor.

Why avoid unnecessary catheter-tubing disconnection?03-application / patient-care
Answer

Maintains a closed system and reduces contamination risk.

Graph View

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