Pin this info!
Many patients, especially ones admitted into a hospital, will often have a foley catheter inserted into their bladder. This device can be especially useful for patients with incontinence or patients on bedrest. They are also used with a continuous bladder irrigation (CBI).
At the hospital where I am currently employed, patients will often have one insertedafter they have had surgery. Just be warned that they typically should not be used longer than a few days or the patient will be at an increased risk of getting a urinary tract infection (UTI).
What is it? PurewickAvoiding injury Emptyingthe bag Drain the tubing Prevent kinking Dementia Removal
What Is It?
A foley catheter (or indwelling urinary catheter) is simply a device with a bag at one end, and a tube at the other. The tube is inserted into the patient's urethra. This drains urine from their bladder down the tube that leads to the bag.This bag can be placed beside their bed or chair. Some of them are even designed to attach to the patient's leg.
These are not to be confused with a straight catheter or condom catheter.
A condom catheter is similar except it is not internal. They can only be used on males. It works very much like a condom hence the name. Instead of going inside the urethra, a stretchy plastic material that is attached to the tubing is wrapped around the penis. There are skin prep wipes and adhesive sprays that can be used to help the condom stay on the penis.
A straight catheter is only used for a very short amount of time. It still goes inside the urethra, but after all of the urine is drained out of the bladder, it is immediately taken back out. Some patients with bladder issues use these on themselves outside of the hospital. It can also be use in order to obtain aurine sample.
A purewick catheter is a fairly new device that allows for a female to have a catheter that isn't invasive. The only catch is that it is required to stay connected to low intermittent suction in order to work. If you have suction available to you, it is much preferred over an indwelling.
The device itself is banana shaped. It has a slight curve in order to snugly form around the groin area. It is a tube with wicks that are placed flush against the urethra that sucks the urine as the patient goes. It stretches from the labia to the gluteus. The end with the clear tubing faces upwards while the other end tucks between the gluteal muscles.
Purewick catheter instructions
The tube pointing upwards connects to a separate suction tubing which connects to the suction machine (wall vacuum) on the wall. This tube brings the urine to a canister that is also attached to the wall.
As the canister fills up, you have to empty it. To do this, you simply turn off the suction, take out the canister, and empty the contents out into the toilet. In order to measure the output, you either read the numbers on the canister, or simply empty it out into a graduate cylinder. Just don't forget to turn the suction back on afterwards.
The catheter should be replaced either every 8-12 hours, or when it is visibly soiled.
It's a good idea to make sure the tubing is not hanging out over the bed where it could possibly be tripped over which could cause injury. If necessary, coil the tubing and lay it next to the patient's leg on the bed.
It is common to attach the tubing to the leg with a special kind of tape or a device called a statlock (pictured) while the bag is placed next to the bed. This prevents the tubing from being tugged or worse, being pulled out.
This not only causes a lot of pain, it can also lead to injury. I have seen a foley catheter that had been pulled out and it is not a pleasant sight. Lots of blood was coming out of their urethra so I'm sure there was damage done internally.
The reason why it bleeds so much when pulled out is because water is pushed into the tubing towards the end which causes a tiny balloon to form. This keeps it in place and prevents it from slipping out. You must also be very careful when performing perineal care, which should be done at least every 12 hours.
In order to properly take it out, that balloon must be deflated by removing the water with a syringe. This will prevent injury from occurring since the tubing will flatten out and can slide out of the urethra with ease. A CNA is typically allowed to do this as long as they have been taught how to.
Emptying The Bag
Emptying a foley catheter is a very easy task. There is a short tube at the bottom of the bag with a clip attached. These clips come in various types but they all work similarly. Some of them have a little flap on the bag that the end of the tubing slides into so the tube doesn't drag the ground.
Just grab a graduate cylinder (picture) and place it underneath the tube. Unsnap the clip and let the urine drain from the bag into the graduate. Make sure the container doesn't overflow. If necessary, empty the contents and come back to finish draining the bag.
If you are measuring the output, make sure you set the graduate on a flat and level surface and wait for the urine to stop sloshing around in the container. Then bend down to eye level and observe to obtain a proper measurement.
Drain The Tubing
One trick I have learned to make sure you are emptying 100% of the urine is to drain all of the urine in the tubing leading to the bag. How do you do this?
You simply straighten out the tubing itself and make sure it is lower than the patient's bladder. You may have to tilt the tubing back and forth to drain all of it. It may take awhile to drain everything especially if more and more urine drains from the bladder into the tubing as you empty it.
The reason I emphasize doing this is because if it isn't done, excess urine could be left inside the bladder. This is not only uncomfortable for the patient, it could also cause a urinary tract infection (UTI).
I have had patients that appeared to not have any output from their foley catheter. But once I drained the tubing, more and more urine entered the tubing. The more I drained, the more urine came until there was over a thousand milliliters (mL) in the bag.
That means there was that much urine in their bladder. If I wouldn't have emptied the tubing and allowed more urine to drain, who knows how long the urine would've stayed in there.
I have encountered this situation multiple times. I always empty all of the urine out of the tubing before emptying the bag itself. You truly don't know how much output a patient has until you have done so.
Foley catheter bag
Prevent Kinked Tubing
Make sure the tubing itself isn't kinked. A common way for it to become kinked is for the tubing to be underneath the patient's leg. Make sure the tubing goes over their leg so this doesn't happen.
Anadult diapercould also kink the tubing. To prevent this, make sure it isn't too tight around their leg. Also, whichever side of the brief the tubing comes out of, make sure you hook the bag to the side of the bed on the same side.
Whenever a patient is being turned to help preventbed sores, it is a good idea to place the bag on the side of the bed that the patient is leaning towards so the tubing won't go over the patient's higher leg. This allows the tubing to be as low from the patient's bladder as possible for better draining.
If these methods aren't working and you suspect their bladder may be full, use a bladder scanner if one is availableto check.
Patients With Dementia
Many patients withdementiawill forget they have a foley catheter or simply will not understand what it does. It often makes them feel like they have to urinate. This will often cause them to try to get up causing afall riskor they may continually insist that they needbathroom assistance.
If this happens, you may have to remind them that they have one. Using the term "urine bag" may make it easier for them to understand. Explain what it is and what it does. I will sometimes show them the bag itself and point to the urine inside reemphasizing that they don't have to worry about using the bathroom.
Some patients may even attempt to pull out the tubing. If a patient attempts this, emphasize that not only will it hurt, pulling it out can also cause serious injury to their urethra. You may have to hide the tubing in order for them to leave it alone.
An easy way to do this would be to put an adult diaper on them. This may be all it takes to prevent them from tugging at it. Another method is to position the tubing to go all the way to the foot of the bed instead of over their leg. Just be sure the patient doesn't move their legs around or it may get pulled out.
When Should the Urinary Catheter be Removed?
Due to the high risk of catheter associated urinary tract infections (CAUTI), a urinary catheter should be removed as soon as possible. Here are some guidelines that will help determine if it should be kept in or removed.
- Continuous bladder irrigation (CBI)
- Urinary obstruction
- Urologic/Gynecologic surgery
- Decubitus ulcers: to assist in healing of open perineal or sacral wounds (stage 3 and 4) in incontinent patients
- Strict intake and output (I&O) that is critical for patient management or hemodynamic instability
- Neurogenic bladder dysfunction or chronic indwelling catheter
- Immobilization due to physical constraints such as a potentially unstable fracture, multiple traumatic injuries, epidural, femoral central venous catheter (CVC), palliative care, intra-aortic balloon pump (IABP), etc.
- Incontinence alone without any other justifiable reason
- Morbid obesity
- Dementia / confusion
- Patient request
- Nursing convenience
- Urine specimen collection: straight catheterize if unable to obtain otherwise
What are Caregiver Duties?
List of Caregiver Supplies and Equipment
From Foley Catheter Basic Info and Tips to Home
Have something to say about what you just read? Leave a comment in the box below.
How to Manage a Loved One’s Health Condition - Caregiverology
Feb 08, 23 01:14 PM
Finding out that your loved one has a health condition that will see them needing round-the-clock care can be devastating. You might be confused about what their condition entails, the care they’ll ne…
5 Ways to Help Your Parents Adjust to Assisted Living - Caregiverology
Feb 08, 23 11:39 AM
You tried your very best, you tried to delay it for as long as you could, and it breaks your heart to take this life-changing decision. But now that the inevitable is upon you, you must face it.
A Guide to Becoming an Adult-Gerontology Nurse Practitioner
Feb 01, 23 12:31 PM
Nursing is a rewarding career, no matter the specialty you enter. However, if you’re passionate about caring for older people and helping them with their unique health needs, adult-gerontology nursing…
What teaching should be provided to patients with Foley catheters? ›
- Make sure you wash your hands before touching your catheter.
- Always keep the drainage bag and tubing below the level of your bladder.
- Do not let your tubing loop over bed rails, your legs or onto the floor. ...
- Drink plenty of fluids every day--8-10 glasses of water or liquid.
- Always keep your bag below your waist.
- Try not to disconnect the catheter more than you need to. Keeping it connected to the bag will make it work better.
- Check for kinks, and move the tubing around if it is not draining.
- Drink plenty of water during the day to keep urine flowing.
Always keep the bag below the level of your bladder. Cleanse around the urinary opening daily with soap and water. When cleansing the urinary catheter, remember to push germs away from you. This means to start at the urinary opening and wipe down towards the drainage bag with soap and water.How do you explain a Foley catheter? ›
A Foley catheter is a common type of indwelling catheter. It has soft, plastic or rubber tube that is inserted into the bladder to drain the urine. In most cases, your provider will use the smallest catheter that is appropriate.What are the responsibilities a caregiver in caring for patients with catheter? ›
- Keep a record of the patient's water intake and urine output.
- Maintain the drainage bag beneath the bladder level without touching the floor.
- Make sure the patient well-hydrated.
- Maintain genital hygiene for the patient.
The nurse must be vigilant in assessing the patient for proper catheter placement. If the PA waveform suddenly looks like the RV or PCWP waveform, the catheter may have become misplaced. The nurse must implement the proper procedures for correcting the situation.What should you assess before putting in a Foley catheter? ›
Perform physical assessment of the bladder and perineum. Palpate the bladder for signs of fullness and discomfort. (Bladder emptying may also be assessed using a bladder scanner per agency policy). Inspect the perineum for erythema, discharge, drainage, skin ulcerations, or odor.How often do you have to flush a Foley catheter? ›
Catheter flushes and bladder washouts can be carried out as and when required, or routinely (for example once or twice a day) to prevent a build-up of mucus within the bladder. The procedure is carried out using a bladder syringe and 0.9% Sodium Chloride (salty water) flushed through the catheter.How often do you clean a Foley catheter? ›
If you have a catheter (such as a Foley) that enters through the urethra, clean the urethral area with soap and water 1 time(s) daily as you were taught by your healthcare provider. You should also clean after every bowel movement to prevent infection.What are the guidelines for proper catheter care? ›
Do perform peri-care using only soap and water or a similarly gentle cleaning agent. Do keep the catheter and tubing from kinking and becoming obstructed. Do keep the catheter system closed when using the urine collection or leg bags. Do replace catheters and urine collection bags that become disconnected.
What are 3 reasons a Foley catheter may be necessary? ›
to drain your bladder before, during or after some types of surgery. to deliver medicine directly into the bladder, such as during chemotherapy for bladder cancer. as a last resort treatment for urinary incontinence when other types of treatment have been unsuccessful.What is the difference between a catheter and a Foley catheter? ›
An indwelling urinary catheter is inserted in the same way as an intermittent catheter, but the catheter is left in place. The catheter is held in the bladder by a water-filled balloon, which prevents it falling out. These types of catheters are often known as Foley catheters.What are the steps for inserting a Foley catheter? ›
Lubricate tip of catheter with sterile lubricant jelly. Holding the coiled catheter in dominant hand, gently introduce the catheter tip into the urethral meatus. Slowly advance the catheter through the urethra into the bladder. If substantial resistance is met, do not force the catheter!What are the main duties and responsibilities of a caregiver? ›
Caregiver Job Duties:
Providing a warm and welcoming care environment. Listening to a patient's needs, wants, and other suggestions about their care. Attending to patient's hygienic needs such as bathing, dressing and undressing, cleaning teeth or dentures, and using the bathroom.
But, as a CNA, catheter care simply involves cleaning the exposed part of the catheter, the skin around it and making sure the catheter tubing and bag are positioned properly. This is a cleaning skill, not a technical skill. CNAs don't put catheters in or take them out.What should a caregiver do when they notice that there is no urine in a catheter drainage bag? ›
- Call your nurse or doctor in the case if your catheter comes out. ...
- In the case where you experience some pain, and there is no urine in your bag, or if you are making less urine than usual, seek your doctor or nurse's help.
Wash the catheter well using cooled, boiled water and a mild liquid soap. Rinse well with cooled, boiled water to remove all traces of soap. Flick the catheter dry. Avoid touching the end which goes into your urethra.What is the most common complication caused by Foley catheter? ›
The main risk of using a urinary catheter is that it can sometimes allow bacteria to enter your body. This can cause an infection in the urethra, bladder or, less commonly, in the kidneys. These types of infection are known as urinary tract infections (UTIs).What is the best position to insert catheter to patient? ›
Ensure patient privacy and have patient in supine position. Place waterproof sheet and/or kidney dish between patient legs. Perform hand hygiene & don gloves. Gently withdraw catheter on exhale if possible, with rotation movements if necessary.What are the 6 indications when an indwelling catheter is appropriate? ›
Appropriate indications for urinary catheters include:
Acute urinary retention or obstruction. Hospice/comfort care/palliative care. Accurate measurement of urinary output in critically ill patients. Required strict immobilization for trauma or surgery.
Can you use normal saline to flush a Foley catheter? ›
Flushing a Foley catheter involves injecting a normal saline solution into the tube until the urine drains from the bladder into the bag at the desired rate.How much normal saline do you use to flush a Foley catheter? ›
Inject 60-120mL's of the saline solution into the catheter. Gently withdraw the fluid from the catheter with the syringe. If resistance is met: ✓ Slightly reposition the catheter if possible and try again to withdraw fluid.How do you remove a blocked Foley catheter? ›
- Identify the “Balloon Port” at the end of the catheter (see the diagram). ...
- Cut the valve off the “Balloon Port”. ...
- Wait for all the water to trickle out. ...
- Pull the entire catheter out with a steady pull. ...
- Throw all the tubing and the collection bag away.
The most optimal color for your urine is a pale yellow. If it is a darker yellow or orange, it can mean you are becoming dehydrated. An orange urine could indicate a serious liver condition. Darker brown can be caused by foods or medication.What PPE should be worn when emptying a catheter bag? ›
Staff should always wear appropriate PPE, e.g. disposable apron and gloves when emptying a catheter bag. Before putting on PPE, staff should wash hands thoroughly and dry using paper towels.How should a CNA Clean an indwelling catheter? ›
Following perineal care, obtain fresh water and a clean washcloth to wash the catheter tubing. Firmly grasp the catheter to prevent tugging on it and gently wash the tubing with soap and water.How do you Clean a Foley catheter nurse? ›
Use soap and water or perineal wipes to clean the tissue around the meatus and outside of the catheter. To avoid contaminating the urinary tract always clean wiping away from, NEVER toward the urinary meatus. Do not pull on catheter or the contaminated area will re-enter the urethra.How do you reduce sediment in a catheter? ›
Stay hydrated. Drinking plenty of fluids can help prevent mineral buildup in the urine as well as prevent overall bladder irritation. We recommend avoiding alcohol, acidic juices, and caffeine which can all be dehydrating. Maintain healthy fiber intake.How often should a catheter bag be changed? ›
Urinary drainage bags must be discarded every seven (7) days from first use when: • switching from a leg bag to a large drainage bag; disconnecting the drainage bag from the catheter; and • the bag is leaking, damaged, discolored, stiff and brittle or a strong odor persists after cleaning.What happens if a catheter is left in too long? ›
Longterm indwelling urethral catheter can cause several complications such as lower urinary tract infections, tissue damage, pain, hemorrhage and encrustation of catheter leading to blockage.
What are the 2 types of catheters? ›
There are two major types of intermittent urinary catheters: Non-hydrophilic catheters, which are uncoated catheters, and hydrophilic intermittent catheters which are coated with a slippery surface to make insertion and withdrawal easy.What is a 2 way vs 3-way Foley? ›
Foley catheters may be 2-way or 3-way. A 2-way catheter has two lumens – one to drain fluid (in this case urine) and one to inject fluid or medication (in this case water into the balloon). There are also 3-way urinary catheters which have a third lumen to flush water into the bladder.What are the 3 main types of catheters? ›
- Straight intermittent catheters.
- Hydrophilic catheters.
- Closed system catheters.
A procedure usually performed by a medical professional, flushing a 3-way Foley catheter, also referred to as bladder irrigation, is the process of clearing blood clots or other particles slowing or blocking the flow of urine.What is the most common Foley catheter size? ›
The average catheter size used by adult men is between 14FR to 16FR. Most men use 14FR catheters. The average catheter size used by adult women ranges from 10FR to 12FR. Most women use 12FR catheters.Why straight cath instead of Foley? ›
Foley in the 1930's) are meant for longer term use by patients who are unable to use the toilet themselves. Straight catheters are simply straight tubes (without the balloon feature of a Foley catheter). They are meant for quick drainage of the bladder and not for long term use.How do you pee after a Foley catheter? ›
- Don't push or put effort into urinating. Let your urine pass on its own.
- Don't strain to have a bowel movement.
Gently insert the catheter into the urethra opening until urine begins to flow out. (You may want to use a mirror to see better.) Then insert it about 2.5 centimetres (1 inch) more. Let the urine drain into the container or the toilet.What teaching might you provide for a patient that has urinary retention? ›
Voiding at frequent intervals empties the bladder and reduces risk of urinary retention. Allow the patient to listen to the sound of running water, or dip hands in warm water/pour lukewarm water over perineum.What type of precautions are followed for a person with a catheter? ›
Do perform hand hygiene immediately before and after handling the catheter or drainage system, and use clean gloves while handling the catheter or drainage system. Do perform peri-care using only soap and water or a similarly gentle cleaning agent. Do keep the catheter and tubing from kinking and becoming obstructed.
Which instructions do you include in the teaching care plan for a patient with cystitis? ›
- Personal hygiene. The patient should be informed to wipe from front to back after urination or bowel movement, and also to wear cotton underwear.
- Increase fluids. ...
- Patterns of voiding. ...
- Take your antibiotics as directed. ...
- Drink extra water and other fluids for the next day or two. ...
- Avoid drinks that are carbonated or have caffeine. ...
- Urinate often. ...
- To relieve pain, take a hot bath or lay a heating pad set on low over your lower belly or genital area.
There is urine leaking around the catheter
Check for and remove any kinks in the catheter or the drainage bag tubing. This could also indicate your catheter is blocked (see above). Go to your local emergency department immediately as the catheter may need to be changed.
Staff should always wear appropriate PPE, e.g. disposable apron and gloves when providing catheter care. Before putting on and after removing gloves, staff should wash hands thoroughly and dry using paper towels.
Management and treatment for incontinence
increased fluid intake of up to two litres a day. high-fibre diet. pelvic floor exercises. bladder training.
- Assess the symptoms of UTI.
- Encourage patient to drink fluids.
- Administer antibiotic as ordered.
- Encourage patient to void frequently.
- Educate patient on proper wiping (from front to the back)
- Educate patient on drinking acidic juices which help deter growth of bacteria.
- Take antibiotics as prescribed.
- Provide patient with routine voiding measures including privacy, normal voiding positions, sound of running water, etc. ...
- Encourage/provide appropriate perineal cleansing. ...
- Provide appropriate catheter care when catheter is present. ...
- Catheterize patient when indicated.
- Drink plenty of liquids, especially water. Drinking water helps dilute the urine. ...
- Try cranberry juice. ...
- Wipe from front to back. ...
- Empty your bladder soon after having sex. ...
- Avoid potentially irritating feminine products. ...
- Change your birth control method.
The most comfortable sleeping position for anybody struggling with a UTI would be any that put the least pressure on your pelvic muscles, such as the foetal position, or if you prefer sleeping on your back, spreading your legs apart.What are the don'ts in UTI? ›
DON'T skip doses or stop taking antibiotics before they're gone. DON'T have sex until fever and symptoms stop. DON'T hold your urine for long periods. DON'T drink caffeinated beverages or alcohol.