Balloon deflating post catheter insertion

[regerterb]

Hi Guys,

I am having trouble with a patient I have on home health with his indwelling urethral catheter.

Twice he has rung stating he presented to the ED as his catheter "fell out" post insertion-first time he said it was because it wasn't in far enough and second time was about 4 hours post insertion he said that there was only 2ml in the balloon the ED nurse deflated.

I have read the ED nurses notes which state that he has pulled on the catheter both times accidentally...I just feel like he is giving me half the story... I check the balloon prior to insertion with 10ml sterile water and both times have put the same amount in. Is it possible for it to deflate in such a short period of time or is it possibly him tugging/fiddling with it has caused the valve to fail that holds the water in place?

Both balloons inflated perfectly pre-insertion and both held the full 10ml post insertion.

He recently suffered a stroke, has problems with his gait and speech. The catheter goes in perfectly each time, clear urine, about 250ml drains freely. Any ideas??

[loriangel14, RN]

Yep. He's likely pulling it out." Gee nurse, I don't know what happened. It just fell out".

[LadyFree28, BSN, LPN, RN]

Could the balloons fail post insertion due to balloon testing prior to insertion?

[Libby1987]

Use a larger balloon and an adhesive anchoring device?

[Kitiger, RN]

It could be a bad batch of catheters. I've had that happen with trach cuffs not lasting, where several trachs in a row had cuff failure. We hadn't done anything differently. Then, the problem resolved, although - again - we hadn't done anything differently.

[regerterb]

Yeah I said that to him as it deflates within 4-8 hours of me seeing him..according to him....we'll see, I have already put an anchoring device to his leg so not sure I will follow it up this week

[dishes, BSN, RN]

Urologists and urology nurses do NOT increase the size of the balloon or inflate the balloon prior to inserting it, because neither of these is evidence based practice and can cause problems such as bladder spasms from too large of a balloon and urethral trauma from the cuff of the balloon after it was deflated.

Before inflating the balloon do you insert the catheter all the way to the Y of the of the drainage and balloon filling ports?

[NuGuyNurse2b]

^ True story: worked one time where a mentally handicapped patient kept being restless with no other issues. He kept pointing to the foley. So we're all thinking it's just something he's not used to. well the dr ordered an xray just to see...turns out the nurse who inserted the foley didn't go all the way and inflated the balloon while it was still in his urethra.