1.
) Catheterization
Definition of the procedure: To obtain urine specimen, and to empty the bladder completely
prior to surgery.
Purposes of the procedure:
- To relieve discomfort due to bladder retention
- To provide gradual decompression of a distended bladder.
- To assess the amount of the residual urine if the bladder is empty completely.
Catheterization Rationale
1. Verify doctors order and identify To provide safety.
patient, Explain procedure To gain cooperation of the patient.
2. Obtain tray, Wash and check tray for To avoid transferring of microorganisms.
needed articles by opening tray using
aseptic technique.
3. Saturate cotton balls with an aseptic To maintain sterility.
solution.
4. Remove catheter aseptically from To maintain the catheter sterile and to insert
bag container, place in sterile tray the catheter easily.
and drop enough amount of KY jelly,
close tray and carry to bedside.
5. Provide privacy, place rubber sheet To protect the mattress from getting wet.
and draw sheet under patient’s
buttocks.
6. Place patient in dorsal recumbent To perform the procedure in a right manner.
position, do diagonal draping. For To provide privacy of patient.
female patient; check if patients
needs preliminary care.
A. Offer bedpan and do perineal To avoid infection.
care/flushing.
B. Remove bedpan. To start the procedure.
7. Place tray between thighs facing the To easily grasp the instruments.
vulva.
8. Adjust light. Place waste receptacle To easily accessible in throwing the waste.
at convenient area.
9. Open tray by bringing top edge of To be able to use the equipment’s by not
cover under buttocks. getting the patient wet.
10. Put on gloves. To protect hands.
To avoid infection.
11. Drape patient with catheterization To expose only the perineum.
sheet.
For FEMALE patient: disinfect the area using Cleanest to dirtiest.
sterile procedure. Clean with cotton balls with To make sure that the equipment’s is clean to
antiseptic in the following order; urinary avoid contamination and infection of
meatus, farther labia minora, nearer labia perineum.
minora, father labia majora, neare labia
majora then urinary meatus (center) always
with the downward stroke.
For MALE: Keep foreskin retracted. Wash off To make sure that the penis is clean and
glans penis around urinary meatus with avoid contamination during insertion of the
cotton balls soaked in antiseptic solution catheter.
using forceps to hold cleansing sponge or
cotton balls. (Disinfect starting from the
meatus going outward.
12. Place kidney basin or bowl near For easily grasp.
patients buttocks.
13. Lubricate catheter about 2’’ from tip To insert the catheter easily.
for female patient and about 6-10 “for
male patient.
14. Place end of catheter inside bowl So that the urine will flow.
before inserting tip into meatus gently.
15. For female patient separate labia To easily insert the catheter.
minora to expose meatus and insert To be able to get the urine without blood.
catheter into urethra about 2 -3’’ or
until urine flows. For male patient,
Grasp the shaft or penis (with left
hand) raising it almost straight up and
insert catheter into the urethra 6-10’’
or until urine flows.
2.) Leopold’s Maneuver
Definition of the procedure: An abdominal palpation using the 4 maneuver to determine the
position, action, attitude, fetal size, and locate fetal part of the fetus inside the woman’s uterus.
Purposes of the procedure:
- To identify the position of the fetus.
- To estimate fetal size and locate fetal parts.
- To systematically observe and palpate the abdomen to determine fetal presentation
and position.
Leopold’s Maneuver Rationale
1. Explain the procedure to the patient. To established rapport and gain cooperation
with the patient.
2. Let patient empty her bladder. To comfort the patient and for accurate
result.
3. Screen. To provide privacy.
4. Place the patient in supine position To relax the abdominal muscle.
with knees slightly fixed.
5. Warm hands. To keep warm and avoid anxiety.
6. Do the first maneuver. While facing To stimulation of finger well cure the
the mother, the examiner palpates abdominal muscle to extract.
the fundus using the fingertips to
identify first the fetal part that
occupies the fundus of the uterus.
7. Second Maneuver: Palpation of the To identify first the fetal that occupies the
fatal back and small parts. Still facing fundus.
the mother, the examiner’s palmar
surface of the hand is placed on one
side of the abdomen to steady the
uterus. While the other hand palpates
the other side in a slightly circular
motion of the fingers from the top to
lower segment of the uterus to feel the
fetal outline.
8. The third maneuver: The maneuver To identify the fetal part presenting over the
should next determine with the right inlet in the right position.
hand (if right handed) which fetal part
presenting over the inlet. This is to
confirm the first maneuver. Still facing
the mother. This is done by gently
grasping the lower pole of the uterus
between the thumb and fingers and
pressing in slightly. If the presenting
part is not engaged, the next step is to
determine the attitude of the head.
9. Finally, the degree of descent is To know the degrees descent that the fetus is
estimate. To do this, the examiner engaged to the uterus.
faces the woman’s feet and uses both
hands. The sides of the uterus just
below the umbilical level are grasped
snugly between the palms of the
hands; the fingers held close together
pointing downward and inwards. If
the hands are placed correctly, the
first points at the little fingers will be on
level with the anterior iliac spine and
the umbilicus. When the presenting
part has descended deeply, only the
small portion of it may be outlined.
Palpation of the anterior shoulder will
aid in assessment of descent of the
vertex.
10. Able to auscultate the FHB by using To make sure that the beating sound of fetus
Doppler or stethoscope, locate is heard inside the uterus.
fundus. Begin listening halfway
between the fundus and the pubis.
Work outward in widening circles until
a beating sound is heard. Compare
the beating with the maternal pulse. If
it is different, count beats for a full
minute.
11. Chart. Time, condition of the mother and the fetus.
3.)
