Foley Cath Question

[oxyjen]

I'm embarrassed to ask this, it's a tiny, detailed (dumb) question. Most Foley catheters are 5cc balloons and the tray comes with 10cc of sterile water. The leur cap (orange) says 5cc/10ml. My foundations book says to inflate with 10cc. I have always filled the balloon with the full 10cc. Why is it called a 5cc balloon if it holds 10cc and you are supposed to inflate it with 10cc? Why isn't it called a 10cc/10ml? (I warned you this was a dumb question.) Thanks if anyone knows the history of why this is so.

One other one. Some say the tubing goes under the leg because it is to be below the bladder level Some say over the leg, to avoid skin pressure (under the leg). How do you do it?

[nursedawn67, LPN]

Hi, I don't know the answer to the first question...but the second question....I put the foley over the leg because of pressure. And most nurses that i have seen put it over also. :)

[maledi]

I think, don't quote me, that the balloon could hold up to 10 ml but you only have to blow it up at least 5 ml. I know that often nurses fill more than 5 ml so we were told to always bring at least a 10 ml syringe when deflating to make sure you get all of it. That's the best answer I can come up with right now.

[oxyjen]

Thanks for responces. I surveyed several nurses last night from different facilities and they were about 50/50 on the over/under question. (I always put it over myself, btw, with the bag always below the bladder)

maladi, thanks for your input about filling the bulb.

[Antikigirl, ASN, RN]

My habit is to fill the balloon with 10cc's because most of the patients I had were elderly, and the tone of the bladder muscles aren't typically up to par, or some had hx of pulling them out (causing stretch). So for me 10cc is pretty standard for the elderly or people use to foleys.

As far as the leg bag, if you have a pt that has fragile skin then I take that into consideration when placing tubing. Also take into consideration mobility...are they bed bound and they move a lot in bed, are they ambulatory, etc.? Not one person is the same, so you adapt to the patient need.

I have had people bed bound but be quite the mover and shaker...so putting it under the kneecap caused pulling when they moved legs, same with over the leg with folks use to tugging at lines (confusion, nervousness). I usually check with the patient and ask how they prefer it done :). And watch those blankets...it is a Murphy's law that "all blankets will assume a snake like position around any/all tubing and legs" LOL!

Either way...it is important to check for flow. That is a part of our assessments anyway. If it isn't flowing well...think gravity and position and fix the situation to the best solution for flow and pt.

[ckh23, BSN, RN]

One other one. Some say the tubing goes under the leg because it is to be below the bladder level Some say over the leg, to avoid skin pressure (under the leg). How do you do it?

As long as the bag is below the bladder, the Foley will drain. I put it over the leg because it doesn't take much pressure to block off the flow of urine.

[Harleygirl]

This pertains to the "if it says 5 ccs, and they supply 10 ccs, how much do I inflate it?"

In my experience, you put the 10 ccs in. Especially with elderly.

Just a tidbit to add, I have never had it happen to me personally, but I have heard of a state surveyor actually pulling the inflation solution out of the balloon, measuring it, and checking it against what cc balloon was ordered and in place. If it was even 1 cc off, you get cited for not following doctors orders.

STUPID.

[meownsmile, BSN, RN]

Harleygirl,, i have never seen a doctor write an order for a specific size or amount of fluid to fill the balloon. EVER.

Now i can see them maybe citing overfill if it is a 10 and there is 12, but still that isnt against dr order unless the doctor specifically writes "do not fill balloon more than Xml"

Just not sure how they could justify a citation for that.

[ray2512]

5cc over

[MajorDomo]

If I am not mistaken for the the extra H2O is for filling the channel that leads to the balloon. Hence, if you look at the individual foleys not from kits (I think Bard has each size listed) it states something like 5ml balloon fill with 10ml sterile water or 3ml balloon fill with 5ml, ect..

MajorDomo

[HyperRNRachel]

I think, don't quote me, that the balloon could hold up to 10 ml but you only have to blow it up at least 5 ml. I know that often nurses fill more than 5 ml so we were told to always bring at least a 10 ml syringe when deflating to make sure you get all of it. That's the best answer I can come up with right now.

Good point.

[oxyjen]

Major, I never thought about the amount it takes to fill the channel!