Clamping a Newly Inserted Foley

catlady, BSN, RN · Aug 23, 2006

I was always taught that, as well; however, there is evidence to suggest that the Foley should be allowed to drain, regardless of volume.

Here are a few examples you might want to review:

https://emedicine.medscape.com/article/778456-overview?form=fpf

https://brooksidepress.org/mil_ob_gyn/?page_id=1794

Silverdragon102, BSN · Aug 23, 2006

here in the UK many years ago I was taught this but then we changed to place the urine bag in the bed level with the patient if we was worried that too much urine was draining.

sweetcheekers · Aug 23, 2006

We were taught that the "old school" of thought was to clamp at 1000ml of output, but no one could justify why so it was not considered to be knowledge based practice so we did not abide by it. I don't see the issue with it. If a person were to sit and void, their bladder would empty itself of whatever volume is present without any harm.

SouthernLPN2RN, MSN, RN, APRN, NP · Aug 23, 2006

I feel that the bladder should be drained. Stagnant urine breeds bacteria so I think it's best to empty it while you can. Other than possibly causing a bladder spasm, I haven't seen a pt have a problem with draining >1000. I myself had 1700 out after I had a hysterectomy and subsequent lazy bladder, lol!

TiffyRN, BSN, PhD · Aug 23, 2006

I was taught the same thing about clamping at 800-1000ml. I thought it was hogwash. I have however seen two patients in my career (not a lot I know) that had the issues we were warned about. What I was warned about was that it could cause hypotension. The theory being the sudden release of pressure from the pelvic wall will allow blood to rush to fill that area and cause hypotension/dizziness.

I did see this with two patients as I mentioned. Both were patients that required intermittent caths every 6-8 hrs for neurogenic bladders. If you allowed more than about 700-800 to drain at once they would be cause faint and hypotensive. Why doesn't it happen when people void on their own? Well, in my experience MOST (not all) of the time people don't void that much at once. Also, with as many people as I've cath'd that had large volumes initially, I've only seen these two patients that had issues so it's obviously not that common.

TazziRN, RN · Aug 23, 2006

I was taught to clamp, but not because of bladder injury. If the pt is older or a spinal pt and is hypertensive, the BP can drop too much if the bladder empties too fast.

Otessa, BSN, RN · Aug 24, 2006

I haven't seen bladder collapse but I have seen my share of painful bladder spasms with 1000 cc emptying before I knew better....

NurseLatteDNP, MSN, DNP, RN · Aug 24, 2006

I have also seen bladder spasms one time.

GatorRN · Aug 24, 2006

I was taught to clamp off after 1000ml drained when first placing a foley. The rationale was that by draining too quickly the bladder decompresses to fast and can cause spasms and hypotension. I have seen both in different pts, so I always clamp now at 1000, give it some time then unclamp, and reclamp if necessary.

banditrn · Aug 24, 2006

I was taught to clamp off after 1000ml drained when first placing a foley. The rationale was that by draining too quickly the bladder decompresses to fast and can cause spasms and hypotension. I have seen both in different pts, so I always clamp now at 1000, give it some time then unclamp, and reclamp if necessary.

Yes, that's what I was taught also. And being relieved of a liter of fluid will definitely allow relief of a full bladder.

NurseBeefcake · Aug 25, 2006

we were taught the same except we clamp if 500 mL comes out very quickly.