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Discussion

New Advice. Please Help

Hello

I am an RN that works in LTC. I have been a nurse for a year. I have insert foley catheters before and had no issues.

One hour before my shift was over I had to replace a catheter on a 80 year old man because of leakage. I removed the old catheter and there was some blood in the tip of the old catheter. I replaced the catheter with another and I did receive urine return. I inflated the balloon and the resident said he could feel the catheter. I deflated and adjusted the catheter, reinflated the balloon, and this time blood came out of the foley. The resident was frustrated with me and did not want me to do anything else with the catheter. There was another nurse present in the room during the insertion also. I passed along all of the information to the NOC shift and upon leaving the resident reported that the catheter was leaking. The resident was sent out to the ED during the NOC shift. What could have happened? I feel awful about it. Will I be in trouble? Did I cause trauma? Just want some advice. I am worried about the resident and my job.

:nailbiting:

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    Blood can come out of a foley, sometimes it looks like a LOT of blood too - but it is common. It is an 80 yr old man, who more than likely has an enlarged prostate. Due to potentially irritating the prostate, some nurses here in Australia actually do not do foleys on males, especially older ones! But you could have just inadvertently upset the prostate a little bit - not a big issue at all.

    Sometimes its a little scratch on the urethra that causes a bit of blood post-insertion, it's really common and I have no idea why the resident would be annoyed. If he is annoyed, he clearly doesn't know that can sometimes happen. It's not a big issue, as long as it was all sterile no infection should happen!

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    Another thought too, he may have developed a UTI. Especially if he has had the catheter for awhile. If the surrounding area was grossly inflamed it wouldn't have taken much to make it bleed.

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    It's always a good idea to put that thing in as far as it will go while it's still sterile, all the way to the bifurcation of the inflation port. Then you can be sure that you're past all possible narrow spots. Inflate the balloon, then gently, gently pull back until you feel the slightest resistance.

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    I was taught that technique in nursing school (insert all the way in to the port) I've seen a few residents go the the ER after nurses inflated the balloon while still in the urethra causing a tear

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    don't know about this particular situation, but in LTC, most of the time

    improper routing of the tubing is the cause for leakage

    so a lot of times it's not necessary to replace

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