 Welcome to Nursing School Explained and today's video on how to place a fully catheter in a female patient. Keep in mind that I only have a model here that we'll be using today. So always make sure that you follow the appropriate steps of identifying your patient and explaining the procedure. New York catheterization kit, as I have it here, this is a simulation kit but pretty much the catheterization kits will tell you what is in the kit in terms of the contents. Make sure that you always check your patient for a latex allergy as some catheters come in a latex format and then you'd have to go change that. And we always want to prep the patient by providing pericare before we insert the catheter. And especially in female patients, it helps if you inspect the peri area first and take a look at the anatomy since it can be very different from patient to patient given on their body habits. Maybe if they've had childbirth or multiple or if there's any other anatomical differences. It also helps to have a little gooseneck lamp available so that you can actually see the anatomy a little bit better. And so when you do pericare, it's a perfect time to actually familiarize yourself with the patient's specific anatomy and then you can have all the equipment ready that you need. I like to have a catheterization kit. Maybe have a second kit as a backup there just in case something happens with the sterile technique or even have a second pair of sterile gloves available just in case you contaminate your sterile field with the gloves and so that you're ready to go and you don't have to leave the room and then come back with those supplies. So let's say we've already done pericare on our patient and I have my female patient here. So I'm going to set up my sterile field now. So after providing hand hygiene, I open up the catheterization kit, the package and I can actually use the plastic bag it comes with as a trash bag that I will keep right here handy at the bottom of the bed. Now keep in mind there might also be special circumstances where your patient might not be able to open up her legs because of maybe a hip surgery or any other restrictions that they have from a musculoskeletal system. So always make sure that you are aware of those limitations ahead of time and then it always comes with a sticker that actually tells you then the name, the date and the insertion of who did it. Now I can get rid of all these things for now and then in order to open my sterile kit I will use the tab that I have and I will pull it away from me first and then open up the sides. Remember that only one inch of your sterile drape is considered you can touch it so it's considered non-sterile so make sure you don't touch it inside the one inch margin. And so now right here I can see that I have my sterile gloves right here what I like to do is turn this kit over so that I'm now lined up more straight and not in this diamond shape from my vision. I take my sterile gloves and I can take them away from the patient. I could even put them on a bedside table or any other thing that I would need. I don't my sterile gloves and then I can just get rid of this. Now that my hands are sterile I need I can grab this wrapper because it is still sterile on the inside make it so the outside doesn't touch me and I'll just get rid of it for now. Then every catheterization kit comes with two drapes one that is a just a waterproof pad and the other one is called a fenestrated drape which has a hole in the middle and what I like to do I like to use these because it gives me a little bit of a better area to work with. The shiny side always goes down as it is the waterproof side. Remember that your gloves are sterile so you don't want to touch anything on the patient with your sterile gloves right now. So now I have a nice sterile field and then I can use the other towel to set it up here and extend my sterile field. Now I can certainly touch the inside of the box because it is sterile and so now I have a nice lane to work with here. I have my swab sticks to clean the patient I open them up and I personally like to take them out of the wrapper and place them so that when I'm when I have one hand that touches the patient and it's not sterile that I can just grab the swab sticks with my sterile hand and it'll be much easier and this will just go on the pile that I have with my wrappers. This is an extra that I don't need. I have my lubricant here. I squeeze it into the catheterization tray and then I will take out this is trash also. I can take out my tray and I have a nice lane again here. Now in this kit I have the actual catheter which comes nicely curled up and it comes where the catheter is wrapped again in plastic. This tends to want to fling around so it's best if you hold it at the tip and then just kind of slide it out or the other option it's perforated so you can just open up this perforation and let the catheter be unwrapped here. I'm paying attention to my wrapper so it doesn't touch anything outside the sterile field and then drag on to the sterile field and again I can leave this in here and my trash can just go away. Now then here I have my pre-filled syringe which I will take and hook up to the balloon inflation port of the catheter and check the policy where you work because the policy might say to inflate the balloon ahead of time or some policies now say don't do that so in this case I'm not going to do that but I'm ready here with my syringe that is hooked up to the balloon inflation port and then what I can do is I can unravel this here and just stick the catheter tip into the lubricant and I want to make sure that I lubricate the first inch or so of the catheter then I can leave it on the tray here and now that I'm all set to go I have my cleaning swaps I have my lubricant and I have my catheter ready to go so now I will contaminate my left hand by touching the patient and open up the labia so that I then can clear with my right hand which is my dominant hand so I will go ahead and touch the patient being very aware that now my left hand becomes contaminated and is not sterile anymore and I open the labia and I've already inspected the anatomy but now I can see the urethra here and I want to make sure that I have a nice opening and the labia majora is pulled to the outside so that when I insert the catheter it doesn't drag on the labia majora dragging bacteria into the urethra opening I will take my cleaning swap sticks and clean I have a lot of difficulty here so it's always nice if you have a second set of hands that might be able to hold hold things open I want to clean from the bottom from the top to the bottom on one side first and then I just throw this in my trash I clean on the other side throw it away and then I clean it from the top to the bottom on the urethra opening now I'm ready for catheter insertion and now I'm ready to insert the catheter I've already lubricated the tip and I will start by inserting the catheter into the urethra and tell the patient to bear down I have to be very careful that when I insert the catheter that the tip of my gloves don't touch the patient's labia majora when I insert them because otherwise again I could be contaminating the catheter after the tip of the glove touches the catheter here and I also need to be careful that the catheter on the insertion does not touch the glove of my left hand that I'm using to hold the labia open and this can be somewhat tricky but on an actual patient it slides in a lot easier than on this model so I go until I see urine flowing out of that catheter once I see that I insert the catheter another inch to inch and a half to make sure that I am not inflating the balloon in the urethra once that's done and I've advanced the catheter about an inch to an inch and a half after I've seen the urine flow I know that I'm in the bladder in the right spot so now I can go ahead and use my left hand to stabilize the catheter over here and then I use the syringe port and insert the 10cc sometimes you have to stabilize it here inflate the balloon with the full 10cc and make sure that you hold the plunger down as the syringe is empty if you don't do that if you let go of the plunger it'll deflate automatically so hold the plunger down then disconnect gently tug on the catheter until you feel resistance that means that the catheter is now at the bladder neck and then we can secure the catheter at this y bifurcation to the patient's leg with the leg securement device now I take the bag and I can once it's secured to the patient I'll take it and with this nice little hook that we have here I'll hook it to a non-movable part of the bed and then by gravity it will drain it will fill up and once it stops draining I can take my bag and I can measure the urine output which is also important because that's part of the things that I need to chart after I insert my catheter so the catheter is now attached to the non-movable part of the bed my sterile procedure is done so I gather all my supplies and this really you just have to rip this penetrated drape otherwise you can't really get it off and you can take all your supplies and this is all goes in the trash you take off your sterile gloves you perform your hand hygiene and then you take you don clean gloves and then you take care of your patient keeping them comfortable and covered a few things that are important to note on the catheter insertion is once your non-dominant hand becomes contaminated by touching the patient because you have to hold the anatomy to clean the patient don't touch the sterile field again with that non-dominant hand and the other thing is make sure that the catheter back always sits below the level of the bladder so that it can drain with gravity once you've done your procedure make sure you make sure that the patient is comfortable and that you document your findings which includes the size of the catheter the size of the balloon the urine output that you use sterile procedure and how much urine output there was on the initial insertion and then also how the patient tolerated the procedure thanks for watching this video on catheterization on a female patient here on nursing school explain see you soon