Completely confused about this Foley Catheter issue...

Register Today!

  1. This is a discussion on Completely confused about this Foley Catheter issue... in Nursing Issues On Patient Safety, part of General Nursing ... So I work in ED... pt is in and has a UTI per her labs and the doc confirms. He orders a FC...and I...

    by May 10, '12
    So I work in ED... pt is in and has a UTI per her labs and the doc confirms. He orders a FC...and I insert it. Everything I do is textbook, including as soon as urine starts flowing into foley I advance 2 more inches before inflating balloon. About half hour later I return to room and pt is looking like she is in pain....she says "it burns - the catheter." Now based on how she characterizes the pain and the UTI being present, I am not thinking for one second that the balloon is in the urethra. I get an order for 1 of Dilaudid and push, and she feels ok after that. About 2 hrs later however, ultrasound calls (she is admitted to hospital for UTI) and tells the doctor that the balloon is in the urethra. Now, before assuming I am the culprit I did some research...apparently the balloon could be at neck of bladder and subsequently pulled into the urethra past neck of bladder. If given a good tug.

    All I know is I am losing sleep over this because the catheter went in smooth, plenty of urine flowed into bag after insertion (200+ mLs) and I even brought the catheter back gently after the 2 inch advance to make sure it was at neck of bladder. I have put in hundreds of these and never a problem. What the heck happened!
    Read Online


    Print and share with friends and family.
    Compliments of allnurses.com.
    http://allnurses.com/showthread.php?t=708918

    by SunSurfRN May 10, '12 8:39 pm
    ©2013 allnurses.com INC. All Rights Reserved.
  2. 2,673 Views
    Click Tags to Find Similar Topics

  3. 11 Comments so far...

  4. Guide
    May 10, '12 by
    It probably got tugged during the transfer to U/S.

    Dilaudid, for c/o catheter discomfort? Hmm.
    leslie :-D, DeLanaHarvickWannabe, sharpeimom, and 5 others like this.
  5. May 10, '12 by
    Pt had a raging UTI....I mean the white cell count was off the charts. I think the doc was thinking the foley irritated her urethra and the dilaudid was necesary - it was his idea/order. Now that u mention it I am not sure why he didnt order Morphine in this situation.
  6. May 10, '12 by
    I tend to agree with the probability that the cath was pulled on during a transfer. Pt could have tugged on it too. But it does make you question yourself. I feel for you though.
  7. May 11, '12 by
    ya, sounds like it got tugged. Shoot I had one lady that routinely pulled out her foley with an inflated 30ml baloon!!

    Generally speaking, if the baloon is inflated in the urethra it results in immediate pain and frank blood in the urine as the urethra is fractured. You would presumably have known (as would the patient).
    leslie :-D, GrnTea, and sauconyrunner like this.
  8. May 11, '12 by
    Ya, I'd interview the ultrasound techs or transfer team, not that anyone will claim responsibility. I had a patient once, who's cath kept "falling out or it was replaced into the vagina"...ha! Of course urine had been draining so it was not in the vagina! Then one day it fell out again and I asked the nurse on duty to pull the cath out of the trash and inspect it. No leak, nothing. Come to find out, we suspected the daughter was deflating the balloon while visiting. People!...document , document , document.
    maelstrom143 likes this.
  9. Jun 1, '12 by
    Haha! We give dilaudid for headaches, stubbed toes, hang nails. That's pretty much all we do around these parts: push dilaudid.
  10. Guide
    Jun 1, '12 by
    Quote from lfrieds
    ya, i'd interview the ultrasound techs or transfer team, not that anyone will claim responsibility. i had a patient once, who's cath kept "falling out or it was replaced into the vagina"...ha! of course urine had been draining so it was not in the vagina! then one day it fell out again and i asked the nurse on duty to pull the cath out of the trash and inspect it. no leak, nothing. come to find out, we suspected the daughter was deflating the balloon while visiting. people!...document , document , document.
    in 1994" i had a case very similar to the one you have describe, the relative of the patient kept deflating the balloon while they visited, however, in this case it was the husband who did this in order to have intercourse with his wife
    Hay Nars, RN likes this.
  11. Jun 4, '12 by
    well nothing happened and that is good. i guarantee noone will fess up to tugging on that foley during a transfer. i think if Jesus started working in healthcare He'd become a liar also.
    LPNnowRN likes this.
  12. Jun 27, '12 by
    Quote from gitanorn
    in 1994" i had a case very similar to the one you have describe, the relative of the patient kept deflating the balloon while they visited, however, in this case it was the husband who did this in order to have intercourse with his wife
    gross. like could he not just let the poor woman be sick and go without! he was a dog!