What is the specific operation method of urethral catheterization?

People with urinary system diseases or elderly people over 60 years old often have difficulty urinating, and in severe cases, they can't excrete urine at all, which makes the patients very painful. After dysuria, you should go to the hospital as soon as possible, and those who are ineffective in drug and acupuncture treatment should be guided in time.

Catheterization is the insertion of catheter into bladder through urethra under aseptic operation, which should be operated by medical personnel.

There are two kinds of catheterization in clinical application: one is indwelling catheterization; The second is indwelling catheterization. Which one to adopt depends on the purpose of catheterization. Non-indwelling catheterization is often used for temporary treatment or collection of urine samples, and the catheter is removed immediately after catheterization. Indwelling catheterization is often used to continuously drain urine or observe renal function, and the catheter needs to be fixed after being inserted into the bladder.

The specific operation method of urethral catheterization is different because of the different physiological characteristics of men and women.

(1) indwelling catheter: In addition to catheter, sterile glass connecting tube, rubber drainage tube (about 65cm long), urine storage bottle, therapeutic bowl, 200-300ml physiological saline, irrigator, pin, adhesive tape and thin thread rope (for men) should be provided. The specific operation method is as follows:

① Shave off pubic hair and fix the catheter with adhesive tape.

(2) According to the routine catheterization method. After the urine runs out, 60 ~ 80 ml of normal saline is sucked by the irrigator and injected into the bladder from the catheter. If the recovery is successful, the amount of liquid is basically equal to the injection amount, which shows that the catheter is in the right position in the bladder and can be fixed with adhesive tape.

③ Fixation method of male indwelling catheter: Fix the catheter on both sides of penis with butterfly-shaped adhesive tape, then gently wrap the adhesive tape to fix it, and tie the distal folded part of the catheter with a string. The fixing methods of female urinary catheter include: ligating the urinary catheter with string, fixing the distal end with adhesive tape or fixing it with adhesive tape in three directions.

(4) After the catheter is fixed, connect the catheter and drainage tube with a glass nozzle, and put the distal end into a urine storage bottle and hang it beside the bed.

⑤ Fix the drainage tube on the bed sheet with a pin, but keep a certain length to prevent the drainage tube from being pulled out of the urine storage bottle when the patient turns over.

⑥ When intermittent urination occurs, open the catheter regularly.

(2) No indwelling catheter: Before catheterization, a set of sterile catheter bag (1 thick catheter, 2 curved discs, 2 tweezers, 2 hole towels, gauze and a little cotton ball), a rubber blanket and a therapeutic towel, a disinfectant (0. 1% bromogeramine or mercuric chloride), a sterile lubricant and a cotton ball should be prepared.

Do a good job in patients' ideological work before operation, relieve concerns and obtain cooperation. Let the patient wash the vulva with soapy water. If the patient can't look after himself, the nurse can help him. Nurses should ask patients about urethral injury and urethral catheterization history.

① The specific operation method of male patients with urethral catheterization: the operator stands on the right side of the patient and the patient lies on his back. 1/3 Take off his pants to his knees and cover his upper body to avoid unnecessary exposure. Legs flat, slightly apart, blankets and therapeutic towels laid under the hips.

Disinfect vulva. Hold the penis wrapped with gauze in your left hand and push the foreskin backward to expose the glans penis. Hold tweezers with bromogeramine cotton ball in your right hand, and wipe the glans penis, coronary sulcus, penis, pubic mound and scrotum skin from the urethral orifice for 2 ~ 3 times in a rotating motion.

Put on a sterile gloves, put a hole towel on it, and lift the penis from the bottom of the coronary sulcus with the thumb, middle finger and ring finger of the left hand, making an angle of 60 with the abdomen. Separate the urethral orifice with the index finger, hold the vascular clamp or tweezers in the right hand to clamp the head end of the lubricating catheter for 5 cm, and with the help of the fingers of the left hand, gently insert about 18 ~ 20 cm from the urethral orifice, and continue to insert 2 cm after the urine flows out.

After the catheter is inserted, pull out the catheter and let the patient rest.

② The specific operation method of female patients with urethral catheterization: Make preparations before urethral catheterization.

When the operator stands on the right side of the patient, he will be folded to the end of the bed, take off his right trouser leg and cover his left leg. The right leg can be covered with a small blanket, and then a blanket and a therapeutic towel can be placed under his buttocks.

The patient kneels on his back, fully exposes the vulva, and puts the curved plate between his legs.

Disinfect vulva, use tweezers to clamp the new gel cotton ball, and use the cotton ball to scrub the urethral orifice, labia minora and labia majora in turn from top to bottom.

Put on the sterile gloves, spread the hole towel, put the dressing bowl under the hole towel, open the gauze and fold it into a long strip, wrap it around the thumb and forefinger of the left hand in a figure of eight, and then fix the labia majora and labia minora separately. Hold tweezers with mercuric chloride cotton ball in your right hand, wipe both sides of urethral orifice from top to bottom, and then scrub with mercuric chloride cotton ball twice. When finished, remove the bent plate. Hold tweezers in your right hand and clamp the head end of the catheter lubricated with oil cotton ball 5 cm (put the tail end into the urine bottle) and aim at the urethral orifice. Slowly insert about 4 ~ 6 cm. After the urine flows out, insert a little more to avoid the catheter coming out due to the patient's nervous breathing.

After catheterization, pull out the catheter, and then wipe the vulva with gauze to help the patient get dressed and rest.