In the next section of our CNA Skill Set Test Study Guide, we will be covering the procedures for applying a catheter to a patient.
Catheter care is an important skill assessment for the CNA practical exam. However, you could be required to apply a condom catheter, or an indwelling catheter. An indwelling catheter is as catheter that runs inside the body. This catheter allows urine to drain from the bladder to a collection bag that is outside the body. A condom catheter is a silicon catheter that is applied to the outside of the penis and collects the urine into a urine collection bag. The condom catheter is less invasive but is only used on males.
Just like any skills set, remember that you should follow common good practices such as announcing when you arrive, pay attention to contamination, wash your hands, inform the patient of what you will be doing and communicate in a professional manner.
CNA Practical Skill: Indwelling Catheter Care
- Ensure that the patient is positioned appropriately. Females should be placed on their back with their knees bent while a male should be put in a Fowler’s position.
- Position a waterproof pad under their midsection so that the buttocks and the lower area are separated from the bed.
- Remove the clothing so as to expose their perineal area.
- For Women: Use your non dominant hand and separate the labia thus exposing the urethral meatus. This should expose the catheter insertion site.
- For Men: If uncircumcised, then separate the fore skin from the tip of the penis. Hold the penis at the shaft for the remainder of the procedure.
- Insert the catheter.
- Check the perineal area for color, swelling, or any signs of issues.
- Cleanse the perineal area and ensure it is dry before moving to the next step.
- Cleanse the catheter tubing from the area of insertion to the connective tubing.
- If the male is uncircumcised, replace the foreskin over the tip of the penis.
- Place the patient back into a comfortable position and cover their perineal area.
- Take appropriate logs.
CNA Practical Skill: Applying a Condom Catheter
- Place the patient in a Fowler’s position.
- Remove their clothing around the perineal area but ensure to keep other areas covered for the purposes of comfort to the patient.
- Clean the perineal area, especially around the tip.
- Remove the coverings from the condom catheter’s adhesive surface.
- Place the catheter at the end of the penis and roll the sides of the catheter down the shaft towards the body.
- Apply tape down the length of the catheter is a spiral motion. Ensure you never cicle the tap completely because this can cause circulation issues.
- Once secured, connect the catheter to the drainage bag.
- So as to ensure the catheter doesn’t get removed, tape the tubing to the inside of the leg.
- Hang the drainage bag to the bed frame or any other part of the bed that will not move.
- Take appropriate logs.
Remember that with a condom catheter, it must be removed and the area cleaned at least once a day.
Where do CNAs insert catheters? In Michigan, this is outside the scope of practice.