Indwelling Urinary Catheter Care in Children

Indwelling Urinary Catheter Care in Children

An indwelling urinary catheter is a thin, flexible, germ-free (sterile) tube that is placed into the bladder to help drain urine out of the body. The catheter is inserted into the part of the body that drains urine from the bladder (urethra). Urine drains through the catheter into a drainage bag outside of the body.

Taking good care of your child’s catheter will keep it working properly and help to prevent problems from developing.

What are the risks?

  • Bacteria may get into the bladder and cause a urinary tract infection.
  • Urine flow can become blocked. This can happen:
    • If the catheter is not working correctly.
    • If there is a blood clot or sediment in the bladder or the catheter.
  • Tissue near the catheter may become irritated and bleed.

How to use the catheter and the drainage bags

Supplies needed

  • Adhesive tape or a leg strap.
  • Alcohol wipe or soap and water (if you use tape).
  • A clean towel (if you use tape).
  • Overnight drainage bag.
  • Smaller drainage bag (leg bag).

Setting up the catheter and drainage bags

  • Use adhesive tape or a leg strap to attach your child’s catheter to his or her leg.
  • Make sure the catheter is not pulled tight.
  • If a leg strap gets wet, replace it with a dry one.
  • If you use adhesive tape:
    • Use an alcohol wipe or soap and water to wash off any stickiness on your child’s skin where there was tape before.
    • Use a clean towel to pat-dry the area.
    • Apply the new tape.
  • Your child should have received a large overnight drainage bag and a smaller leg bag that fits underneath clothing. Your child may wear the overnight bag at any time, but he or she should not wear the leg bag at night.
  • Make sure that your child:
    • Always wears the leg bag below his or her knee.
    • Always keeps the overnight drainage bag below the level of his or her bladder but does not let the bag touch the floor.
      • Before your child goes to sleep, hang the bag inside a wastebasket that is covered by a clean plastic bag.
      • Secure the plastic bag tightly in the wastebasket. Do not have loose bags around children because of the danger of suffocation.

How to care for your child’s skin around the catheter

Supplies needed

  • A clean washcloth.
  • Water and mild soap.
  • A clean towel.

Caring for your child’s skin and catheter

  • Every day, use a clean washcloth and soapy water to clean the skin around your child’s catheter:
    • Wash your hands with soap and water.
    • Wet a washcloth in warm water and mild soap.
    • Clean the skin around your child’s urethra.
      • If your child is female:
        • Use one hand to gently spread the folds of skin around the vagina (labia).
        • With the washcloth in your other hand, wipe the inner side of her labia on each side. Do this in a front-to-back direction.
      • If your child is male:
        • Use one hand to pull back any skin that covers the end of the penis (foreskin).
        • With the washcloth in your other hand, wipe the penis in small circles. Start wiping at the tip of the penis, then move outward from the catheter.
    • With your free hand, hold the catheter close to where it enters your child’s body. Keep holding the catheter during cleaning so it does not get pulled out.
    • Use your other hand to clean the catheter with the washcloth.
      • Only wipe downward on the catheter.
      • Do not wipe upward toward your child’s body, because that may push bacteria into the urethra and cause infection.
    • Use a clean towel to pat-dry the catheter and the skin around it. Make sure to wipe off all soap.
    • Wash your hands with soap and water.
  • Have your child shower every day. Do not let your child take baths.
  • Do not use cream, ointment, or lotion on the area where the catheter enters the body, unless your child’s health care provider tells you to do that.
  • Do not use powders, sprays, or lotions on your child’s genital area.
  • Check your child’s skin around the catheter every day for signs of infection. Check for:
    • Redness, swelling, or pain.
    • Fluid or blood.
    • Warmth.
    • Pus or a bad smell.

How to empty the drainage bag

Supplies needed

  • Rubbing alcohol.
  • Gauze pad or cotton ball.
  • Adhesive tape or a leg strap.

Emptying the bag

Empty the drainage bag (the overnight drainage bag or the leg bag) when it is ⅓–½ full, or at least 2–3 times a day. Do not clean the drainage bag unless your child’s health care provider tells you to do that.

  1. Wash your hands with soap and water.
  2. Detach the drainage bag from your child’s leg.
  3. Hold the drainage bag over the toilet or a clean container. Keep the drainage bag lower than your child’s hips and bladder. This is to prevent urine from going back into the tubing and into the bladder.
  4. Open the pour spout at the bottom of the bag.
  5. Empty the urine into the toilet or container. Do not let the pour spout touch any surface. This precaution is important to prevent bacteria from getting in the bag and causing infection.
  6. Apply rubbing alcohol to a gauze pad or cotton ball.
  7. Use the gauze pad or cotton ball to clean the pour spout.
  8. Close the pour spout.
  9. Attach the bag to your child’s leg with adhesive tape or a leg strap.
  10. Wash your hands with soap and water.

How to change the drainage bag

Supplies needed

  • Alcohol wipes.
  • A clean drainage bag.
  • Adhesive tape or a leg strap.

Changing the bag

Replace your child’s drainage bag with a clean bag once a month. Replace the bag sooner if it leaks, starts to smell bad, or looks dirty. To change the bag:

  1. Wash your hands with soap and water.
  2. Detach the dirty drainage bag from your child’s leg.
  3. Pinch the catheter with your fingers so that urine does not spill out.
  4. Disconnect the catheter tube from the drainage tube at the connection valve. Do not let the tubes touch any surface.
  5. Clean the end of the catheter tube with an alcohol wipe. Use a different alcohol wipe to clean the end of the drainage tube.
  6. Connect the catheter tube to the drainage tube of the clean bag.
  7. Attach the clean bag to your child’s leg with adhesive tape or a leg strap. Avoid attaching the new bag too tightly.
  8. Wash your hands with soap and water.

General instructions

  • Do not pull on the catheter or try to remove it. Tell your child to never do that. Pulling can damage internal tissues.
  • You and your child should always wash hands before and after you touch the catheter or drainage bag. Use a mild, fragrance-free soap. If soap and water are not available, use hand sanitizer.
  • Always make sure there are no twists or bends (kinks) in the catheter tube.
  • Always make sure there are no leaks in the catheter or drainage bag.
  • Have your child drink enough fluid to keep his or her urine pale yellow.
  • Do not let your child take baths, swim, or use a hot tub.
  • If your child is female, make sure she wipes from front to back after having a bowel movement.

Contact a health care provider if:

  • Your child’s urine is cloudy.
  • Your child’s urine smells unusually bad.
  • Your child’s catheter gets clogged.
  • Your child’s catheter starts to leak.
  • Your child says that his or her bladder feels full.

Get help right away if:

  • Your child has redness, swelling, or pain where the catheter enters his or her body.
  • Your child has fluid, blood, pus, or a bad smell coming from the area where the catheter enters the body.
  • The area where the catheter enters your child’s body feels warm to the touch.
  • Your child has a fever.
  • Your child has pain in his or her abdomen, legs, lower back, or bladder.
  • You see blood in the catheter.
  • Your child’s urine is pink or red
  • Your child has nausea, vomiting, or chills.
  • Your child’s urine is not draining into the bag.
  • Your child’s catheter gets pulled out.

Summary

  • An indwelling urinary catheter is a thin, flexible, germ-free (sterile) tube that is placed into the bladder to help drain urine out of the body.
  • The catheter is inserted into the part of the body that drains urine from the bladder (urethra).
  • Take good care of your child’s catheter to keep it working properly and help prevent problems from developing.
  • You and your child should always wash hands before and after you touch the catheter or drainage bag.
  • Do not pull on the catheter or try to remove it. Tell your child to never do this. Pulling can damage internal tissues.
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