Introduction

Foley catheterization, also known as Indwelling catheterization, is a common medical procedure involving the insertion of a catheter into the bladder through the urethra. This procedure is performed to assist with urinary elimination and management in patients who are unable to void urine on their own or require accurate measurement of urinary output. Nursing students need to understand the purpose, types, considerations, indications, contraindications, procedure steps, potential complications, and overall patient care associated with indwelling catheterization.

 

Foley catheterization Definition

Foley catheterization involves the insertion of a flexible catheter into the bladder to drain urine and maintain urinary function. The Foley catheter is a specifically designed catheter with an inflatable balloon at its tip that helps keep the catheter securely in place within the bladder.

Purpose of Foley Catheterization

The primary purposes of indwelling catheterization include:

• Urinary drainage in patients unable to void naturally.
• Measurement of accurate urinary output in critically ill patients.
• Monitoring and management of urinary retention.
• Facilitation of urine collection for diagnostic purposes.

 

Types Foley Catheter

There are different types of Foley catheters, including:

1. Two-Way Foley Catheter: Consists of a drainage lumen and an inflation lumen for the balloon.
2. Three-Way Foley Catheter: Includes an additional lumen for continuous bladder irrigation.

Considerations

Before performing the procedure, nursing students should consider the following:

• Informed Consent: Obtain informed consent from the patient or their legal guardian.
• Hygiene: Maintain strict hand hygiene and follow aseptic techniques.
• Equipment: Ensure that all required equipment is available and sterile.
• Privacy: Maintain the patient’s privacy and dignity throughout the procedure.

 

Indications

Indwelling catheterization may be indicated in situations such as:

• Acute urinary retention.
• Surgery involving the genitourinary tract.
• Accurate measurement of urine output in critically ill patients.
• Management of chronic urinary retention.
• Severe urinary incontinence in patients with limited mobility.

 

Contraindication

Indwelling catheterization may be contraindicated in cases of:

• Urethral trauma or obstruction.
• Recent genitourinary surgery or trauma.
• Known hypersensitivity to latex or catheter materials.
• Active urinary tract infection.

 

 

Foley Catheterization Procedure

Preparation

• Wash hands and put on appropriate personal protective equipment (PPE).
• Explain the procedure to the patient and obtain informed consent.
• Gather sterile catheterization kit, Foley catheter, sterile gloves, antiseptic solution, lubricating gel, sterile drapes, and drainage bag.

Positioning

• Assist the patient into the supine position with knees slightly bent and feet flat on the bed.

 

Catheter Insertion

• Prepare the sterile field and drape the patient appropriately.
• Put on sterile gloves.
• Clean the perineal area with an antiseptic solution, starting from the urethral meatus and moving outward.
• Lubricate the catheter tip with sterile lubricating gel.
• Gently insert the catheter into the urethra until urine flows, indicating entry into the bladder.
• Advance an additional inch.
• Inflate the balloon with the recommended volume of sterile water to secure the catheter in place.
• Attach the catheter to the patient’s thigh using adhesive or catheter-securing device.
• Connect Drainage System
• Connect the distal end of the catheter to a sterile drainage bag.
• Ensure proper positioning of the drainage bag below the level of the bladder to facilitate urine drainage.

Documentation

Document the procedure, including catheter size, amount of balloon inflation, patient tolerance, and initial urine output.

 

Complications of Indwelling or Foley Catheterization

Potential complications include:

• Urinary tract infections.
• Catheter-associated bacteriuria.
• Trauma to the urethra or bladder.
• Catheter blockage or kinking.
• Bladder spasms.
• Hematuria (blood in urine).

 

Conclusion

Indwelling catheterization is a vital procedure in nursing practice, serving various purposes related to urinary elimination and management. Nursing students must master the technique, adhering to strict aseptic principles, patient safety, and ethical considerations.

 

Exam-Related Questions

1. What is the primary purpose of indwelling catheterization?
2. Name two types of Foley catheters and their differences.
3. List two contraindications for indwelling catheterization.
4. Describe the steps involved in preparing a patient for indwelling catheterization.
5. What complications are associated with indwelling catheterization, and how can they be prevented?

 

Must Read – Urinary Catheterization – Procedure, Types, Considerations

 

Additional Information

• Regular catheter care and perineal hygiene are crucial to prevent infections.
• Monitor urinary output and ensure the proper functioning of the catheter and drainage system.
• Patients with indwelling catheters are at risk of developing catheter-associated urinary tract infections (CAUTIs), so infection prevention measures are crucial.

For a comprehensive understanding and practical training, nursing students should seek guidance from experienced instructors, clinical placements, and hands-on practice in simulated environments.

 

FAQs

1. What is Foley catheterization?

   • Foley catheterization is a medical procedure involving the insertion of a flexible tube (catheter) into the bladder through the urethra to drain urine.

2. How is a Foley catheter inserted?

   • A Foley catheter is inserted into the bladder through the urethra under sterile conditions. The catheter is advanced until it reaches the bladder, and then a small balloon at the tip of the catheter is inflated to hold it in place.

3. What are the indications for Foley catheterization?

   • Foley catheters are commonly used to drain urine in patients who are unable to urinate on their own due to various medical conditions such as surgery, urinary retention, or neurological disorders.

4. What are the risks and complications associated with Foley catheter insertion?

   • Risks and complications of Foley catheterization include urinary tract infections, bladder injury, urethral trauma, and discomfort. Proper sterile technique and catheter care can help minimize these risks.

5. How long can a Foley catheter remain in place?

   • The duration a Foley catheter can remain in place varies depending on the patient’s condition and the reason for catheterization. In general, Foley catheters are used for short-term or long-term drainage, and the duration is determined by the healthcare provider.

6. What is the procedure for Foley catheter removal?

   • Foley catheters are typically removed by deflating the balloon and gently pulling the catheter out of the urethra. Removal should be done carefully to minimize discomfort and trauma.

7. Can Foley catheterization cause urinary tract infections (UTIs)?

   • Yes, Foley catheterization can increase the risk of urinary tract infections due to the introduction of bacteria into the urinary tract. Proper catheter care and hygiene are essential to reduce the risk of UTIs.

8. How does a Foley catheter work?

   • A Foley catheter works by draining urine from the bladder into a collection bag outside the body. The balloon at the tip of the catheter keeps it in place inside the bladder.

9. What are the different types/sizes of Foley catheters?

   • Foley catheters come in various sizes and types, including silicone and latex materials. The size of the catheter is selected based on the patient’s anatomy and medical condition.

10. Are there any alternatives to Foley catheterization?

    • Yes, alternatives to Foley catheterization include intermittent catheterization, suprapubic catheterization, and external catheters (condom catheters). The choice of catheter depends on the patient’s needs and medical condition.

 

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