Overview
This lecture covers the step-by-step process for inserting and removing a Foley catheter in a female patient, including preparation, techniques, and troubleshooting tips.
Preparation and Patient Setup
- Wash hands and provide patient privacy before starting the procedure.
- Position bed at a comfortable working height to prevent back strain.
- Position patient with knees bent and hips open for optimal access and lighting.
- Ask about allergies to shellfish (betadine) and latex before beginning.
Sterile Field and Equipment Preparation
- Open the sterile catheter kit using proper technique (open away, sides, toward yourself).
- Wear sterile gloves, touching only the inside cuff while donning.
- Place drapes: first under the patient (shiny side down), second around the genitals exposing only needed area.
- Prepare betadine swabs or alternatives (chlorhexidine/non-latex catheters if allergic).
- Open lubricant and prepare catheter; test balloon’s integrity if manufacturer recommends.
Insertion Technique
- Contaminate non-dominant hand to hold open the labia (left hand if right-handed).
- Use three betadine swabs: first wipe furthest from you, then closest, then down the middle.
- Lubricate catheter tip and inform the patient before insertion.
- Insert catheter until urine is visible; once urine returns, inflate balloon per manufacturer’s instructions.
- Gently tug catheter to ensure balloon placement, then clean up the area.
Securement and Bag Placement
- Secure catheter tubing to the patient’s leg with a stat lock, avoiding placement under the leg.
- Attach drainage bag to an immobile part of the bed below level of hips to prevent backflow and infection.
Removal of Catheter
- Wear gloves and use an empty syringe to deflate the balloon by withdrawing fluid from balloon port.
- Gently remove catheter while supporting the patient; dispose of catheter properly.
- Perform or assist with perineal care after removal.
Troubleshooting Common Issues
- If catheter is inserted into vagina, leave it as a marker and insert a new one into the urethra.
- A swab stick can be used as a placeholder in the vagina to avoid repeat misplacement.
- Recognize anatomic challenges (obesity, post-partum swelling) may require extra care and lighting.
Key Terms & Definitions
- Foley catheter — a flexible tube inserted into the bladder to drain urine.
- Betadine — an antiseptic solution containing iodine used for skin disinfection.
- Stat lock — device used to secure the catheter to the patient’s leg.
- Meatus — the external opening of the urethra.
Action Items / Next Steps
- Practice proper sterile technique with a catheterization kit.
- Review alternatives for patients with iodine or latex allergies.
- Ask instructor for additional tips if encountering difficult anatomy.