 Welcome to nursing school explained in today's video on the insertion of an indwelling catheter in a male patient. Keep in mind that this is always a sterile procedure and we have to make sure that we follow the sterile field items to the T when we perform this procedure. Let's take a look at this. First of all our catheter kit will always come with a label and it'll tell you the contents of the package. Make sure that you check beforehand if the patient might be allergic to latex or iodine because the catheter itself sometimes contains latex or the cleaning swabs or solution that the kit comes with contains iodine. So if that happens make sure that you consult with your policies and procedures and switch those items accordingly. I personally like to use the bed as my working surface. Some people might prefer to use an over bed table and that is really up to you. I just if the patient is able to open up their legs and tolerate that the catheter is in between their legs here and that this is my sterile working field I prefer this because to me it's much easier to navigate the sterile field. And then of course we always want to provide peri care before we go ahead with the procedure and this also allows us to identify the anatomical landmarks and possibly any anatomical things that we need to pay attention to. In this case our patient here is circumcised and this is important to note because we want to make sure that we retract the foreskin and clean around the glans penis before we go ahead and insert the catheter and then also we'll have to retract the foreskin back over the glans penis once the catheter is insertion to prevent any complications. So in order to get started we want to make sure we perform hand hygiene and then we open up our package. This plastic bag that the package comes with can serve as a little trash bag that you want to put at the back of your bed so you don't want to put it across otherwise you'll have to reach across the sterile field to do that. Now then remember that you always want to start by opening up your sterile field box by opening up the package away from you. So I'll start by opening it away and then open each side. Remember that one inch of the sterile field parameter I can touch but no more than that. So when it comes to the last flap I want to make sure I just grab it on the outside that will eventually sit on the bed. Now this one is a little stubborn which can definitely happen so you just kind of need to play with it a little bit and wiggle it around so that it stays nicely open. I then like to place it this way and right away I can see that my sterile gloves here are on the top of my box so I'll take those and I'll put them somewhere aside from my sterile field. In this case I'll just place them on the side here. I could use the patient's abdomen for example to do that and remember not to turn your back on your sterile field. I done my sterile gloves being careful not to contaminate anything. Now the wrapper of the gloves here on the inside is sterile so I can grab it with my sterile gloves and then just toss it because I haven't touched anything else. Each catheter kit comes with a sterile towel and also what's called a fenestrated towel which has a cut-off edge here and that is has an opening in the front. I like to use it because it allows me to expand my sterile field by just draping this over the patient's genitalia. Strandy side always goes down. My hands are sterile I can rearrange my tray now and I'll actually move this away a bit and then use the other towel to extend my sterile field being careful not to touch the bed or anything else. So now I have a nice working lean here and I don't have to worry about the catheter that might get pulled or any other things to get in the way it contaminated. Now these right here are the swap sticks. This particular kit comes with two. I'm only going to use one and I like to open them up and actually take them out of the wrapper so then later when my non-dominant hand is contaminated by touching the patient I don't have to mess around with this and they will be easily accessible and my trash again goes away. Then the kit also comes with a pre-filled 10 ml syringe as well as some lubricant so I can now take this tray and place it here on to my sterile tray. I use the lubricant and place it on my tray here then the lubricant can go in my trash pile over there and then the catheter here tends to be pretty flimsy in this box so you want to make sure that it doesn't touch anything. Sometimes you can slide it out easily but make sure that you hold on to the wrapper and the catheter because it has a tendency to be flimsy then it could just end up somewhere on the bed and not be sterile anymore. I get rid of my wrapper now I will take my catheter tip and I place it inside the lubricant at least one to two inches. I want to make sure that I lubricate them well and as you can see it's flimsy so I pay particular attention to this end of the catheter. I also want to take my pre-filled syringe and hook it up to the Y port right here which will allow me to inflate the balloon once it is in place. Now the balloon is at the end or fairly towards the end of the catheter right here some manufacturers or hospitals will tell you to inflate the balloon before you insert it to test it but that is mostly not common practice anymore so we just won't do this at this time. So right now I have my sterile filled lined up I am ready to go here my catheter is ready and lubricated now I'm going to clean the patient with my three swab sticks and since I'm right-handed I will use my non-dominant left hand to touch the patients in Atelier being very aware that my hand now becomes contaminated and I can't touch anything else on the sterile filled with my left hand and like I said before this purse patient is uncircumcised so I'm going to need to retract the foreskin to expose the glands penis here and be able to clean it with my first swab stick I clean around the opening in a circular motion from the opening away and then my swab stick does not go back on my sterile tray but it just goes on my trash pile the second swab stick I use from where I start stopped with the first one and again clean in circular motion toss it and then the third one starts where the second one stopped and continue to clean in a circular motion now I'm ready to insert this catheter now that I have cleaned the urinary miatus and the glands of the penis I'm ready to insert my catheter I make sure that it's lubricated and then I tell the patient to take a deep breath and exhale and as the patient exhales I gently insert the catheter being careful that with the tips of my gloves I don't touch the tip of the penis as I'm inserting because otherwise I would contaminate my gloves and then by feeding the catheter in I would basically drag bacteria in there so I want to be careful not to do that now be keep in mind that with a male patient you might feel resistance on some point this might be the prostate it helps to maybe gently twist the catheter to get through the prostate and also coach your patient to take a deep breath as this can be uncomfortable so you insert the catheter until you see urine flowing out and you might have to give yourself a little more slack here once you see the urine flowing as I'm seen right now you want to continue inserting the balloon and in the male patient it's perfectly fine to go all the way to the bifurcation which is the end of the catheter where is that Y piece at this point my sterile procedure is complete I can now let go of my left hand stabilize the catheter so it doesn't slide out and then inflate my balloon make sure to inflate the entire syringe or whatever is recommended by the manufacturer then hold the port to disconnect the syringe otherwise the balloon will automatically start to deflate again like it's doing now so I hold the plunger once it's completely inserted and then I take it out I can get rid of the syringe and then I gently pull the catheter back until I feel resistance which means that now the balloon is at the bladder neck at the at the end of the urethra so in this uncircumcised patient I want to make sure I pull the foreskin back over the glands penis otherwise I might cause some problems there going down the road and then my sterile procedure is done so now I can gather my equipment and the easiest way to do this is to just tear this fenestrated drape and remove it and since I might have some lubricant on my sterile gloves and I no longer need to be sterile I can remove my sterile gloves do hand hygiene and then down clean gloves once I've done the clean gloves I'll take my catheter and usually there's a leg securement device that will allow me to secure this catheter to the patient's thigh and again check your policy on how that's supposed to be attached to the patient's thigh or whatever other part as I lower the catheter back it will fill with urine I'm going to attach the catheter back with its hook to a non movable part of the bed that's usually a hook on the bottom and then I'm just going to wait and see until it stops draining in the meantime because this might take a little while I can gather my equipment and all the things that I'm no longer going to need and I'll just throw them away then I'll take care of my patient make sure they are comfortable and provide them privacy at this point I no longer need to really assess their genitals but I want to assess their urine output and as you can see here it's stopped stopping to flow now so now if I look in my catheter bag keep in mind I want to keep the bag below the level of the bladder but I'm just going to show you what it looks like and then here you can measure how much the patient had as urine output that you can then chart as your urine output now keep in mind the bag is not exact because it's a bag so depending on where the gravity is it might be a little bit different so the best way to check the urine output is to use this drainage port and then put it in a measuring cup and that way you have the exact measuring of the urine output once you inserted the catheter make sure you chart your procedure and make sure your patient is comfortable thanks for watching this video on nursing school explain about catheter insertion and amelotation please also watch the female catheter insertion as the anatomy is a little bit different and I'll see you soon right here on nursing school explain thanks for watching