BEDPANS AND URINALS

Bedpans serves as a receptacle for urine and feces for clients who are restricted to
bed.
Urinals used by male clients for urination.

PURPOSES:
-

To provide a receptacle for elimination of waste materials for patients who are
confined to bed.
To obtain a urine or stool specimen for laboratory examination.
To obtain an accurate measurement/assessment of the clients urine output
or stool.

EQUIPMENT:
-

Clean bedpan / urinal.

Bedpan cover.
Toilet tissue.
Basin of water, soap, wash cloth & towel for clients use in washing hands
after.
Plastic bag or waste receptacle.

PROCEDURE:
1. Check the clients physical status to determine whether a bedpan or urinal is
necessary.
2. Wash hands and put on clean gloves.
3. Explain procedure to the client.
4. Close the door or bed curtain to provide privacy.
5. Raise the bed to 45 to 90 degrees.
6. Place the client in a recumbent position with your hand under the
lumbosacral area of the back of the patient, ask the client to raise the
buttocks as you push the pan into position.
7. For urinals, place it between slightly spread legs w/ the bottom of the urinal
resting on the bed.
8. Leave the client for a time, to provide privacy during elimination, or if not
possible, just step outside within calling distance if client suddenly needs
assistance.
9. When the client signals, return promptly.
10.Put on clean gloves and if necessary wipe the genital area with tissue
(anterioposterior).
11.Remove the bedpan carefully to prevent contents from spilling.
12.Cover & carry the bedpan or urinal to the bathroom, and if ordered, measure
the urine output.
13.Collect a specimen of urine or feces, if ordered.
14.Empty contents into the toilet and flush.

15.Thoroughly clean the pan and wash with disinfectant solution and handled
brush. Dry pan and return to storage unit.
16.Remove and dispose gloves.
17.Give the client a basin of water and soap, and a towel so the client can wash
hands and perineal area if desired.
18.Place the bed back in low position to provide comfort.
19.Wash hands to prevent infection.
20.Document.

CATHETERIZATION
Urinary Catheterization is the introduction of a catheter through the urethra into
the bladder.

PURPOSE:
-

To relieve discomfort due to bladder distention.

To assess the amount of residual urine if the bladder empties incompletely.
To obtain a urine specimen.
To empty bladder prior to surgery.
To facilitate accurate measurement of urine output for critically ill clients
whose output needs to be monitored hourly.
To prevent urine from contacting an incision after perineal surgery.
Used with comatose patients.

TYPES OF CATHETER:
1. Straight catheter
- This catheter is a single lumen tube with a small eye opening about 1/2 inch
from the insertion tip. These are one-time-use catheters, usually used to
obtain a urine specimen for laboratory purposes.
2. Foley catheter / Indwelling catheter / Retention catheter
- There are two types of Foley catheters, the two-way and the three-way.
- The two-way Foley catheter is an indwelling catheter that has 2 lumens, the
larger lumen drains urine from the bladder to the collection bag and the
smaller lumen is used to inflate the balloon near the tip of the catheter to
hold the catheter in place within the bladder.
- The three-way Foley catheter has an extra lumen for instilling medications or
irrigation fluids.
3. Condom catheter / External catheter
- This type of catheter is not inserted into the urethra. Instead, a special
condom is attached to a catheter to keep the catheter in place and to collect
urine.
- Typically necessary for men who dont have urinary retention but have
urinary incontinence.

EQUIPMENT:
-

Sterile Catheter of Appropriate size

Pair of sterile gloves
Waterproof drape
Antiseptic solution
Cleansing balls
Forceps
Water soluble lubricant
Prefilled syringe with sterile water (10cc)
Collection bag and tubing

PROCEDURE:
1.
2.
3.
4.
5.
6.

Obtain MD order.
Identify patient and introduce self.
Explain procedure to the client to gain clients cooperation.
Gather equipment.
Wash hands and observe appropriate infection control procedures.
Provide privacy and assist patient into supine position with knees flexed and
legs spread.
7. Place a waterproof drape under the buttocks.
8. Open catheterization kit and catheter.
9. Prepare sterile field and put on sterile gloves.
10.Check the balloon for patency.
11.Lubricate the catheter (3-4 in. for females & 6-7 in. for males).
12.For female, separate labia using non-dominant hand. For male, hold penis
with non-dominant hand.
13.For female, use dominant hand to handle forceps, cleanse the peri-urethral
mucosa with cleansing solution. Cleanse anterior to posterior, inner to outer,
one swipe per cotton ball.
14.For male, use non-dominant hand to grasp the penis just below the glans and
hold it firmly upright. Using dominant hand, pick up cleansing ball with the
forceps and wipe from the center of the meatus in a circular motion around
the glans.
15.Identify the urinary meatus and gently insert until 1-2 inches beyond where
urine is noted.
16.Inflate balloon, using 10cc sterile water.
17.Gently pull catheter until inflation balloon is snug against the bladder neck.
18.Connect catheter to the drainage system.
19.Secure catheter to abdomen or thigh, without tension on tubing.
20.Place drainage bag below level of bladder.
21.Evaluate catheter function and amount, color, odor, and quality of urine.
22.Wipe perineal area of any remaining lubricant and return patient to
comfortable position.
23.Remove gloves, dispose all used supplies in appropriate receptacles and
wash hands.
24.Document size of catheter inserted, amount of water in balloon, patients
response to procedure and assessment of urine.
NURSING REPONSIBILITIES:

To acquire adequate training to carry out the procedure.

Accurate assessment of special clinical indication for catheterization.
To minimize trauma and infection risk associated with inserting & maintaining
urinary catheters.
To minimize psychological trauma to the patient.

PERINEAL CARE
Perineal Care is the cleansing of the perineum.
Perineum the region of the body between the anus and the urethral opening.

PURPOSE:
-

To remove normal perineal secretions and odors.

To prevent infection.
To render the perineum clean before and after childbirth as well as surgery or
procedure involving the perineal area.

ADMINISTRATION:
1.
2.
3.
4.
5.
6.
7.
8.

Identify client and introduce self.

Explain procedure to the client to gain cooperation.
Prepare all necessary equipment.
Provide client privacy to promote comfort.
Place client in a dorsal recumbent position and put drape appropriately.
Place the rubber sheet under the clients buttocks.
Position client on a bedpan to prevent any liquid from spilling.
Clean the perineum using the 9 ball technique.
-Pour warm sterile water gently over the vulva.
-Clean the perineal area gently and thoroughly using a sponge held by a pair
of forceps.
-Discard used sponges in a waste receptacle.
-Rinse with sterile water to wash out any remaining solution.
-Dry the perineal area with a dry sponge and apply perineal pad as needed.
9. Return client to a comfortable and safe position to ensure comfort.
10.Document.