Nurse Mary is inserting a urinary catheter into a client who is extremely anxious about the procedure. The nurse can facilitate the insertion by asking the client to:
A. Initiate a stream of urine.
B. Breathe deeply.
C. Turn to the side.
D. Hold the labia or shaft of penis.
Correct Answer: B. Breathe deeply.
When inserting a urinary catheter, facilitate insertion by asking the client to breathe deeply. Doing this will relax the urinary sphincter. Deep breathing can all help create gentle pressure that will loosen the resistance against the catheter.
Option A: Initiating a stream of urine isn’t recommended during catheter insertion. Ask the patient to bear down gently (as if to void) and slowly insert catheter through urethral meatus. If urine does not appear in a female patient, the catheter may be in the patient’s vagina. Leave the catheter in vagina as a landmark, and insert another sterile catheter.
Option C: Positioning of the patient depends on gender. In a female patient: on back with knees flexed and thighs relaxed so that hips rotate to expose perineal area. On a male patient: Supine with legs extended and slightly apart. The patient should be comfortable, with the perineum or penis exposed, for ease and safety in completing the procedure.
Option D: Holding the labia or penis won’t ease insertion, and doing so may contaminate the sterile field. Using sterile technique and dominant hand, clean labia and urethral meatus from clitoris to anus, and from outside labia to inner labial folds and urethral meatus. Or, gently grasp penis at the shaft and hold it at right angle to the body throughout the procedure with a non-dominant hand (now contaminated and no longer sterile). This reduces the transmission of microorganisms.
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