e. Catheterize the Male Patient.
(1) To cleanse the penis, swab the center of the meatus outward in a
circular manner. Continue, using a new cotton ball for each progressively larger circle
(figure 4-5).
Figure 4-5. Cleanse the penis.
(2) To insert a catheter into a male, apply gentle traction and pull the penis
straight up; slightly pinch the end of the penis and insert the catheter 15 to 20 cm (6 to 8
inches). To facilitate the more difficult passage through the male urethra, ask the
patient to breathe deeply; then rotate the catheter slightly. DO NOT FORCE ENTRY
OF THE CATHETER. Discontinue the treatment if the patient has unusual discomfort
or if there is continual resistance to the insertion of the catheter. Report the information
promptly.
(3)
When urine flows, place end of catheter in specimen cup.
(4) Place lid on urine cup and label. Clean up supplies, send specimen to
lab with requisition, and document the procedure.
4-3.
COLLECTING A MIDSTREAM URINE SPECIMEN
a. General. A midstream specimen is a voided specimen collected under
conditions of thorough cleanliness after approximately the first 30 ml of urine has been
voided. The advantage of collecting a voided specimen in this manner is that if
organisms appear in the urine, they are mostly from structures such as the bladder or
kidneys rather than just surface contamination. Cleansing removes organisms from the
urinary meatus. Voiding moves any residual organisms present in the urethra out with
the beginning stream of urine.
b. Important Points. Specimens of urine should not be allowed to stand at
room temperature before they are sent to the laboratory. Bacterial growth is likely to
occur as well as alter other results of the urinalysis. The usual procedure is to store an
aurum (gold) specimen in a refrigerator, if it is not taken directly to the laboratory.
Specimens that are collected from multiple voidings are either refrigerated on the
nursing unit or placed in a container with a chemical preservative.
MD0556
4-6