Changing A Foley Cath...Your Methods

NurseAdida · Jan 11, 2011

Both you and your coworker are right however like your coworker showed you, after you inflate the balloon you have to pull(tag) the catheter back just a little bit to make sure that it's secured in the bladder. That was you really know you are in the bladder. This is very important especially for male clients because they have longer urethra and if you just inflate the balloon and leave it, you may still be in the urethra. That's what I was taught in Nursing school and by my preceptor.

tyvin, BSN, RN · Jan 11, 2011

I would think it would be hard to advance a Foley catheter exactly only one or two ccs. It all depends on the client IMO. Sometimes I advance a smidgen after the urine appears and it's all good and then other times I go a little bit more. I can't pinpoint the reason; it's called individual technique. Above all else wait until the urine appears; no urine, no inflation.

As a charge I've seen more then one bloody mess from inexperienced nurses inflating a balloon in the urethra; unfortunately it's always been a male patient that it's happened to. Please be careful.

Forever Sunshine, ASN, RN · Jan 11, 2011

hello allnurses!
i was taught in school and while studying for the nclex that tbe way to insert or change a foley catheter is to insert it, and once urine starts to flow, push it 1-2 cm more, then inflate the balloon. my co-worker who assisted me in my first unsupervised f/c change said to insert the foley tubing to about 1-2 inches outside the given urethra/ureter, inflate the balloon, then tug on it to confirm placement.
what is your method of inserting a foley?
i've done straight caths and foley changes...the way i think it's supposed to be done is to insert it until urine flows, then 1-2 cm more into the bladder to inflate the balloon. (well, not in straight caths).
feedback please!

I insert it 75% to be positive I am all the way in the bladder, I have only done female catherizations. Haven't had to do a male yet.

I did have to straight cath a female in very poor lighting the other night. I thought that was a success in my book lol.

stacey914 · Jan 11, 2011

I just learned this at school and they tell us 1-2 inches after urine, inflate balloon and then tug.

systoly · Jan 11, 2011

I wouldn't call it a tug (not because I'm a stickler for semantics, but to avoid confusion). You gently pull back on the catheter until you feel resistance.

CaLLaCoDe, BSN, RN · Jan 11, 2011

Male clients:

Lidocaine gel works wonders and I prefer to push slowly and ask my client to breath and use a coude cath when dealing with an enlarged prostate situation.

Female cients:

Good luck finding the winking urethra!

I've heard of those who enter the lady parts by mistake will leave the catheter there, find another cath and work around searching for the urethra

Forever Sunshine, ASN, RN · Jan 11, 2011

Male clients:
Lidocaine gel works wonders and I prefer to push slowly and ask my client to breath and use a coude cath when dealing with an enlarged prostate situation.
Female cients:
Good luck finding the winking urethra!
I've heard of those who enter the lady parts by mistake will leave the catheter there, find another cath and work around searching for the urethra

I have yet to see a winking urethra. I know some of my residents so well I know exactly where their urethras are lol.

CaLLaCoDe, BSN, RN · Jan 11, 2011

I have yet to see a winking urethra. I know some of my residents so well I know exactly where their urethras are lol.

Shakespeare: All hale winking urethra!

Actually, I indeed was taught this. You'll notice as the light plays upon the urethra it will glisten a little, as if it were winking.

This was yet again, a highlight of nursing school!

tyvin, BSN, RN · Jan 11, 2011

I have yet to see a winking urethra. I know some of my residents so well I know exactly where their urethras are lol.

The analogy of the winking urethra isn't far off. It's actually an alien with multiple eyes and you're not sure if it's winking at you or not. All the women you've done must have been a dream because I assure you that multiple teenie orifices staring at you screaming "guess which one is the urethra" is a more accurate picture but I do like the winking urethra too.

I assure you that if you stay in nursing long enough you will get the opportunity to observe this phenomena.

Forever Sunshine, ASN, RN · Jan 12, 2011

The analogy of the winking urethra isn't far off. It's actually an alien with multiple eyes and you're not sure if it's winking at you or not. All the women you've done must have been a dream because I assure you that multiple teenie orifices staring at you screaming "guess which one is the urethra" is a more accurate picture but I do like the winking urethra too.
I assure you that if you stay in nursing long enough you will get the opportunity to observe this phenomena.

Two of them were because their foleys had just fallen out. So the urethra was all "i'm still here!"

One resident is on the chunky side but I get her from the side and its up and to the right for her. I could probably catheterize that woman pitch black with my eyes closed.

Next time I have to catheterize someone I will look for the winking urethra. They did tell us that in school.

king_of_the_hill_fan · Jan 12, 2011

Wow, this is GREAT feedback! I was successful with my female foley changes and the female straight cath - never saw a winking urethra, but I'll be keeping an eye out now!

Oops I meant 1-2 inches of advancement, not 1-2 cm. Well, I guess if the different "methods" work and the foley balloon is in the bladder, it's all good, right?! :yeah: