Changing A Foley Cath...Your Methods

1 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!
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.

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.

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

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.

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 vagina by mistake will leave the catheter there, find another cath and work around searching for the urethra

Quote from CaLLaCoDeMale 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 vagina by mistake will leave the catheter there, find another cath and work around searching for the urethra

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

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

Quote from tyvinThe 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.

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?!