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a procedure performed by a patient to empty the bladder by inserting a catheter into the urethra. The procedure is recommended for patients who cannot empty the bladder completely but can retain urine for 2 to 4 hours at a time and who have mental cognition, some manual dexterity, and the ability to insert a catheter into the urethra. This is generally a clean rather than a sterile procedure.
method Necessary equipment consists of a pan or toilet, two 14 French catheters, a water-soluble lubricant, soap, water, and a clean washcloth and towel; women usually require a magnifying mirror initially to identify the urethral meatus, and men may prefer to perform the procedure sitting on a low stool rather than on a toilet. Women are taught to perform self-catheterization initially in a semi-Fowler's position, using a pan, but later they generally can carry out the procedure sitting on or standing over a toilet. The patient is instructed to clean the urinary meatus and labia or glans penis with soap and water, to grasp the catheter about 2 inches from the tip, and to lubricate the tip before it is gently inserted into the meatus: Women insert about 1½ to 2 inches of the catheter, and men insert 8 inches, or until the urine flows. Urine is allowed to flow into the pan or toilet until the bladder is empty. The catheter is then removed, washed in soap and water, thoroughly rinsed, dried by rolling it in a clean towel, and placed in a clean plastic or paper bag for the next self-catheterization.
interventions The nurse teaches the procedure and ensures that the patient understands its purpose and the need to perform it at designated times, as well as the importance of forcing fluids up to 3000 mL daily unless contraindicated. The nurse makes certain that the patient is able to identify the urinary meatus and perform the procedure.
outcome criteria Regular self-catheterization by the patient who cannot empty the bladder allows the person to work and participate in the normal activities of daily living and to prevent kidney infection and other renal disorders.