NURS 371Assessment, Indwelling and Intermittent Catheterization, Coude and
Suprapubic Catheter Use, CAUTI Prevention, Central Venous Access Devices,
PICC Lines, Implanted Ports, Multi-Lumen Catheters, CVAD Flushing and
Occlusion Management, NG and Orogastric Tube Placement, Gastric Residual
Monitoring, Enteral Feeding Protocols, Stoma and Ostomy Care, Colostomy
Pouching Techniques, Fecal Occult Blood Testing, Preoperative Assessment and
Teaching, Informed Consent, Universal Protocol Compliance, Postoperative
Respiratory, Cardiovascular, Renal, Gastrointestinal, Neuro, Musculoskeletal,
Integumentary, Fluid and Electrolyte Complication Prevention, Blood
Transfusion Reaction Management, Subcutaneous Injection Safety, Patient
Education, Delegation to Nursing Assistive Personnel Exam Questions Verified
and Provided with Complete A+ Graded Rationales Latest Updated 2026
What are common urinary catheter sizes?
14-16 french units
5-30 mL balloon
What are clinical indicators for an indwelling urinary catheters?
1. Relief of urinary retention caused by lower urinary tract obstruction, paralysis, or inability to void
2. Bladder decompression, preoperatively and operatively for lower abdominal or pelvic surgery
3. Facilitation of surgical repair of urethra and surrounding structures
4. Splinting of ureters or urethra to facilitate healing after surgery or other trauma in area
5. Accurate measurement of urine output in critically ill patients
6. Contamination of Stage III or IV pressure ulcers with urine that has impeded healing, despite
appropriate personal care for the incontinence
7. Terminal illness or severe impairment which makes positioning or clothing changes uncomfortable, or
which is associated with intractable pain
,What is rational for intermittent urinary catheters?
1. Relief of urinary retention caused by lower urinary tract obstruction, paralysis or inability to void
2. Study of anatomic structures of urinary system
3. Urodynamic testing
4. Collection of sterile urine sample in selected situations
5. Instillation of medications into bladder
6. Measurement of residual urine after urination (postvoid residual) if portable ultrasound not available
What is rational for a coude tipped catheter?
slightly curved tip that allows for passage past an obstruction
What is rational for a suprapubic urinary catheter?
1. Used in temporary situations like bladder, prostate, and urethral surgery
2. Long term basis in selected patients
What are the steps for inserting a urinary catheter?
1. Review providers order for accuracy and need for urinary catheterization
2. Assess patient's medical and medication history including allergies
3. Gather supplies
4. Provide privacy, hand hygiene, patient ID, allergies, procedure
5. Apply clean gloves, clean table, remove gloves
6. Position patient correctly
7. Place absorbent pad under patient
8. Drape patient for comfort and privacy
9. Perform peri care
,10. remove gloves
11. Open catheter tray
12. Place drape under patient maintaining sterility
13. Apply sterile gloves
14. Place fenestrated drape
15. Organize supplies on sterile field, prepare sterile antiseptic solution for use, open lubricant
16. Remove catheter from tray and lubricate tip appropriate for patient maintaining sterility: Male (8in)
female (4in)
17. Cleanse urethral meatus
18. Insert catheter correctly: maintaining sterility, handle catheter properly 3-4" from tip. Ask patient to
bear down as if trying to void and slowly insert catheter through urethral meatus, advance catheter until
urine flows, when urine appears, advance catheter another 1-2"
19. Inflate balloon if needed
20. Place drainage bag below level of the bladder
What are potential complications during catheterization?
1. CAUTI
2. bladder spasms
3. periurethral abscess
4. Chronic pyelonephritis
5. Urosepsis
6. Urethral trauma or erosion
7. Fistula or structure formation
8. Calculi
What are potential challenges locating the urethra?
1. Obesity
2. Female anatomy changes with age and/or after childbirth
, 3. Patient positioning limitations
What are potential challenged with advancing a urinary catheter?
1. Prostate enlargement
*consider an order for urojet: lidocaine gel that will numb the urethral track
*consider a coude tip catheter
2. Male anatomy differences: circumcised vs. uncircumcised
What is the role of the RN with urinary catheterization?
1. Determine the need for catheterization, but HCP must order
2. Choose appropriate type and size of catheter
3. Insert catheter in patient with urethral trauma, pain, or obstruction
4. Develop a plan of care to decrease risk for infection in patient with indwelling catheter
What is the role of the LPN when placing an indwelling urinary catheter?
1. Insert intermittent or indwelling catheter for uncomplicated patients
2. Irrigate the catheter if obstruction is suspected in stable patients (e.g. long term care)
What is the role of the UAP with urinary catheterization?
1. Provide perineal care around the catheter with soap and water
2. Anchor the catheter in place (upper thigh in women and lower abdomen in men)
3. Notify RN about changes in skin condition, especially around meatus
What are strategies for reducing risk of catheter associated UTIs during insertion and maintenance?
Suprapubic Catheter Use, CAUTI Prevention, Central Venous Access Devices,
PICC Lines, Implanted Ports, Multi-Lumen Catheters, CVAD Flushing and
Occlusion Management, NG and Orogastric Tube Placement, Gastric Residual
Monitoring, Enteral Feeding Protocols, Stoma and Ostomy Care, Colostomy
Pouching Techniques, Fecal Occult Blood Testing, Preoperative Assessment and
Teaching, Informed Consent, Universal Protocol Compliance, Postoperative
Respiratory, Cardiovascular, Renal, Gastrointestinal, Neuro, Musculoskeletal,
Integumentary, Fluid and Electrolyte Complication Prevention, Blood
Transfusion Reaction Management, Subcutaneous Injection Safety, Patient
Education, Delegation to Nursing Assistive Personnel Exam Questions Verified
and Provided with Complete A+ Graded Rationales Latest Updated 2026
What are common urinary catheter sizes?
14-16 french units
5-30 mL balloon
What are clinical indicators for an indwelling urinary catheters?
1. Relief of urinary retention caused by lower urinary tract obstruction, paralysis, or inability to void
2. Bladder decompression, preoperatively and operatively for lower abdominal or pelvic surgery
3. Facilitation of surgical repair of urethra and surrounding structures
4. Splinting of ureters or urethra to facilitate healing after surgery or other trauma in area
5. Accurate measurement of urine output in critically ill patients
6. Contamination of Stage III or IV pressure ulcers with urine that has impeded healing, despite
appropriate personal care for the incontinence
7. Terminal illness or severe impairment which makes positioning or clothing changes uncomfortable, or
which is associated with intractable pain
,What is rational for intermittent urinary catheters?
1. Relief of urinary retention caused by lower urinary tract obstruction, paralysis or inability to void
2. Study of anatomic structures of urinary system
3. Urodynamic testing
4. Collection of sterile urine sample in selected situations
5. Instillation of medications into bladder
6. Measurement of residual urine after urination (postvoid residual) if portable ultrasound not available
What is rational for a coude tipped catheter?
slightly curved tip that allows for passage past an obstruction
What is rational for a suprapubic urinary catheter?
1. Used in temporary situations like bladder, prostate, and urethral surgery
2. Long term basis in selected patients
What are the steps for inserting a urinary catheter?
1. Review providers order for accuracy and need for urinary catheterization
2. Assess patient's medical and medication history including allergies
3. Gather supplies
4. Provide privacy, hand hygiene, patient ID, allergies, procedure
5. Apply clean gloves, clean table, remove gloves
6. Position patient correctly
7. Place absorbent pad under patient
8. Drape patient for comfort and privacy
9. Perform peri care
,10. remove gloves
11. Open catheter tray
12. Place drape under patient maintaining sterility
13. Apply sterile gloves
14. Place fenestrated drape
15. Organize supplies on sterile field, prepare sterile antiseptic solution for use, open lubricant
16. Remove catheter from tray and lubricate tip appropriate for patient maintaining sterility: Male (8in)
female (4in)
17. Cleanse urethral meatus
18. Insert catheter correctly: maintaining sterility, handle catheter properly 3-4" from tip. Ask patient to
bear down as if trying to void and slowly insert catheter through urethral meatus, advance catheter until
urine flows, when urine appears, advance catheter another 1-2"
19. Inflate balloon if needed
20. Place drainage bag below level of the bladder
What are potential complications during catheterization?
1. CAUTI
2. bladder spasms
3. periurethral abscess
4. Chronic pyelonephritis
5. Urosepsis
6. Urethral trauma or erosion
7. Fistula or structure formation
8. Calculi
What are potential challenges locating the urethra?
1. Obesity
2. Female anatomy changes with age and/or after childbirth
, 3. Patient positioning limitations
What are potential challenged with advancing a urinary catheter?
1. Prostate enlargement
*consider an order for urojet: lidocaine gel that will numb the urethral track
*consider a coude tip catheter
2. Male anatomy differences: circumcised vs. uncircumcised
What is the role of the RN with urinary catheterization?
1. Determine the need for catheterization, but HCP must order
2. Choose appropriate type and size of catheter
3. Insert catheter in patient with urethral trauma, pain, or obstruction
4. Develop a plan of care to decrease risk for infection in patient with indwelling catheter
What is the role of the LPN when placing an indwelling urinary catheter?
1. Insert intermittent or indwelling catheter for uncomplicated patients
2. Irrigate the catheter if obstruction is suspected in stable patients (e.g. long term care)
What is the role of the UAP with urinary catheterization?
1. Provide perineal care around the catheter with soap and water
2. Anchor the catheter in place (upper thigh in women and lower abdomen in men)
3. Notify RN about changes in skin condition, especially around meatus
What are strategies for reducing risk of catheter associated UTIs during insertion and maintenance?
