Foley Catheterization

Question 1

The average adult woman will be best suited to a Foley catheter in what range?

Answer 1

14- to 16-French

Question 2

How should a female patient be positioned for Foley catheterization?

Answer 2

Supine in either the lithotomy position or frog-legged position (knees apart and feet together)

Question 3

You have been asked to perform a Foley catheterization on a female patient. Where is the female urethral orifice located?

Answer 3

Below the clitoris and above the vaginal orifice

Question 4

How long is the female urethra? How much farther should a Foley catheter be inserted to ensure proper balloon placement in the bladder?

Answer 4

3.5 - 4 cm;

3 - 5 cm past the bladder opening

Question 5

In what scenario should a Foley catheter be forced into the bladder (against resistance from the external sphincter or male prostatic constriction)?

Answer 5

Never - simply maintain a firm grip and ask the patients to breathe deeply and relax; the sphincter will relax eventually

Question 6

When should the Foley catheter balloon be inflated?

Answer 6

After some urine has come out the catheter, indicating that the catheter is sufficiently within the bladder

Question 7

What is used to inflate the Foley catheter balloon?

What should you do after inflating the balloon?

Answer 7

10 ml sterile water (NOT saline);

gently pull back on the catheter to seat the balloon against the bladder wall

Question 8

True/False.

Water, saline, or air can be used in inflating a Foley catheter balloon.

Answer 8

False. Only sterile water may be used (air causes floating or kinks in the balloon; saline can cause crystallization and catheter valve dysfunction)

Question 9

After insertion, where should a Foley catheter be secured?

Where should the drainage bag be secured?

Answer 9

To the medial thigh (via tape);

below the level of the bladder

Question 10

What are the two most common adverse events associated with Foley catheterization?

Answer 10

Trauma (strictures, narrowing, scarring);

infection (super high risk for bacterial growth in catheters)

Question 11

How can Foley catheter infections be avoided?

Answer 11

STRICT attention to sterile technique;

do not catheterize unless absolutely necessary

Question 12

How can you check to make sure your Foley catheter is in the bladder?

Answer 12

Flush with saline; if saline easily returns, the catheter is in the bladder

Question 13

Should Foley catheters be used for routine management of urinary incontinence?

Answer 13

No. Indwelling catheters have high complication rates (infection, trauma)

Question 14

What is the only absolute contraindication to Foley catheterization?

Answer 14

Urethral injury
(Relative contraindications include urethral stricture, recent urethral or bladder surgery, and a combative or uncooperative patient)

Question 15

The average adult man will be best suited to a Foley catheter in what range?

Answer 15

16- to 18-French

Question 16

How can viscous lidocaine aid in Foley catheterization on a male patient?

Answer 16

It anesthetizes and distends the urethra

Question 17

Where will resistance be encountered in Foley catheterization of a patient with an enlarged prostate?
What can be done?

Answer 17

16 - 18 cm;

use a Coude catheter (tip up) or larger Foley catheter

Question 18

Where should the nondominant hand be during a Foley catheterization on a woman?
On a man?

Answer 18

Spreading the labia minora and pulling the skin rostrally;

holding the shaft of the penis (foreskin retracted) somewhat taut and perpendicular to the patient’s body

Question 19

How common are catheter-associated urinary tract infections (per patient day of catheterization)?

Answer 19

3 - 10% (per patient day of catheterization)

Question 20

Are UTIs ever an acceptable indication for a short-term indwelling urinary catheter?

Answer 20

No.