PBA Foley Flashcards
What should be done outside the patient’s room before inserting a urinary catheter?
insertion
Check EHR for legal order to insert urinary catheter and verbalize one indication for placement.
Check EHR for allergies, specifically iodine, shellfish, and latex.
Gather supplies (kit, chuck, graduated, washcloth.
What are the expected and unexpected outcomes to identify before catheter insertion?
insertion
Expect: 500ml, yellow/clear urine, no pain
Unexpected: anuria, hematuria, painful
What are the initial steps upon entering the patient’s room for catheter insertion?
insertion
Introduce self, identify patient using two client identifiers, confirm physician orders, ask about allergies.
Adjust bed to appropriate height, adjust side rails, provide privacy, perform hand hygiene, and apply clean gloves.
Assess bladder for pain and fullness and explain the procedure to obtain verbal consent.
How should the patient be positioned and prepped for catheter insertion?
insertion
Assist patient to the appropriate position, drape to expose only the perineum, and place a waterproof pad under the client.
Inspect the perineal region and demonstrate perineal care, verbalizing foreskin retraction for an uncircumcised male.
What are the steps to prepare equipment using sterile technique?
insertion
Open catheter kit and “square” outer wrap on the table, apply sterile gloves, and place sterile drape.
Separate top and bottom trays, prepare antiseptic, apply lubricant to catheter, and attach syringe to balloon inflation port.
Restack trays and move kit contents onto sterile drape between patient’s legs, maintaining sterility.
Male catheter insertion - Hand commitment and cleaning method
insertion
Commit non-dominant hand. Hold penis firmly behind the glans with non-dominant hand at a 60-to-90-degree angle.
With dominant hand, using forceps and saturated cotton ball/swab stick, start from the meatus, circle the entire glans x 3 and discard. Repeat the same procedure x 3.
Male catheter insertion - Technique
insertion
Maintain sterile technique, pick up catheter with dominant hand, lubricate if necessary.
Slowly insert catheter tip into the urinary meatus, ask patient to bear down gently, and breathe slowly and deeply.
Advance 7-9 inches, state presence of urine, continue to the catheter bifurcation.
M/F catheter insertion - Securing the catheter
insertion
Inflate the balloon using the sterile water-filled syringe, ask patient about discomfort. Keep positive pressure, remove and discard syringe. Gently pull catheter until balloon is snug against bladder neck.
Change gloves, hand hygiene, secure catheter to a holding device on the leg.
Female catheter insertion - Hand commitment and cleaning method
insertion
Commit non-dominant hand. Separate labia majora and minora with the thumb, middle, and index fingers of non-dominant hand.
Keep labia separated throughout the procedure. Re-swab if necessary.
Female catheter insertion - Technique
insertion
With dominant hand, using forceps and saturated cotton ball/swab stick, clean labia minora furthest from you with a downward stroke, and discard. Repeat same for labia minora closest to you, and straight down the urinary meatus.
Insert catheter tip into urinary meatus, bear down gently, and breathe slowly and deeply.
Advance 2-3 inches, state presence of urine, insert an additional 1-2 inches.
Post catheter insertion - Final steps
insertion
Keep catheter and tubing free from kinking, avoid dependent loops, hang drainage bag below patient’s bladder level on an immovable part of the bed, not allowing it to rest on the floor.
Clip tubing to bottom sheet.
Remove fenestrated drape, verbalize need for peri-care, replace foreskin if retracted.
Dispose of supplies, remove gloves, perform hand hygiene.
Assess patient comfort, answer questions. Lower bed, raise bed rails, place call light within reach.
Outside room, verbalize documentation of procedure including date, time, size of Foley, volume of balloon, urine returned, and patient tolerance.
First steps before urinary catheter removal
removal
Outside room, check EHR for legal order for removal of urinary catheter.
Patient identification and explanation of catheter removal
removal
Introduce self, identify patient using two client identifiers, compare physician orders to wristband, ask for allergies. Explain purpose and procedure in understandable terms.
Ensuring privacy and cleanliness
removal
Provide privacy, perform hand hygiene, and apply clean gloves.
Setting up for urinary catheter removal
removal
Place waterproof pad under client. Verbalize need to empty drain bag/tubing, measure total volume, and dispose in toilet.