NCLEX Review Guide: Elimination & Procedures

Catheter Types & Indications

• Foley catheter (indwelling) has an inflatable balloon to secure placement and allows continuous drainage into a collection bag.
• Straight catheter (intermittent) is inserted temporarily to drain bladder contents and is removed immediately after use.
• Suprapubic catheter is surgically placed through the abdominal wall directly into the bladder, bypassing the urethra entirely.

1. Gather sterile supplies and position patient in dorsal recumbent position
2. Perform hand hygiene and don sterile gloves
3. Cleanse urethral meatus with antiseptic solution (front to back for females)
4. Insert catheter gently until urine flows, then advance 1-2 inches more
5. Inflate balloon with sterile water (usually 10mL) and secure drainage bag

Types of Urinary Diversions

• Ileal conduit (urostomy) uses a segment of ileum to create a stoma on the abdomen where urine drains continuously into an external pouch.
• Continent urinary reservoir creates an internal pouch that patients empty by self-catheterization through a small abdominal stoma.
• Neobladder reconstruction uses intestinal tissue to create a new bladder that connects to the urethra, allowing normal voiding.

Types of Urinary Incontinence

• Stress incontinence occurs with increased abdominal pressure from coughing, sneezing, or lifting due to weakened pelvic floor muscles.
• Urge incontinence involves sudden, intense urge to urinate followed by involuntary bladder contraction and urine loss.
• Overflow incontinence results from bladder overdistention when the bladder cannot empty completely, causing frequent dribbling.
• Functional incontinence occurs when physical or cognitive impairments prevent timely access to bathroom facilities.