Indwelling (Foley) Urinary Catheter Insertion: Post-procedure (Nursing)

by Samantha Rhea, MSN, RN

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    00:04 Now we want to secure the catheter to the patient's thigh.

    00:07 Usually your units going to have a securement device or even come with a catheter kit itself.

    00:13 This is an important step.

    00:15 So that way we can keep patient from getting trauma and also for ideal comfort for a patient.

    00:22 Now make sure you place that collection bag at the location lower than the patient's bladder, as you see in the picture here.

    00:29 This is really important so urine doesn't back up into the catheter itself.

    00:34 Now before you leave the room, and it doesn't matter if it's a male, or if it's a female catheter insertion, make sure you return that bed to the lowest position.

    00:43 Dispose of all those used supplies.

    00:45 And then make sure you remove your gloves and perform diligent hand hygiene.

    00:49 And don't forget to document.

    00:56 Hey, guys, we just inserted our indwelling catheter on our patient.

    01:00 So let's talk about what we do to finish this process up for a male or a female patient.

    01:06 So the first thing to know is securing that catheter securement device.

    01:11 Now just know each facility may not have these, but these are really key to keep this from tugging on your patient.

    01:18 So just know when you're looking at this catheter securement device, most of the time, they're really really sticky.

    01:25 So be really careful about adhering it to the patient.

    01:28 Also just know when we remove the back, we're going to put this on the patient's thigh, not really high, we don't want this looped with the catheter.

    01:38 So what I mean by that is once inserted, you want a little bit of give here, you don't want this super, super tense and pulling while in the catheter securement device.

    01:50 You also don't want so much slack that you're seeing this loop.

    01:55 So what's the problem with this? Okay, so if the patient has urine coming out, if it's secured like this, this can back up into the bladder and provide complications for your patients.

    02:05 So that's not what we want to see.

    02:07 So give the patient a little room here.

    02:09 And then we're going to put our catheter securement device down.

    02:13 And we want to take a moment to take a look at this.

    02:15 Believe it or not, it's actually kind of hard to get used to how to secure this, we've had put the adhesive down for the patient's leg.

    02:23 This is a really helpful tip.

    02:25 You see this device, you see how there's an arrow here and it's pointing up.

    02:30 So think about how the arrow point towards the patient's head.

    02:33 So that's going to be really helpful in the positioning.

    02:36 Also notice this thing kind of swivels around or moves around.

    02:40 And that's again, helpful to move with your patient and to provide less tension.

    02:45 So let me show you how we open that up.

    02:47 So there's a little bit of lock here.

    02:50 And I'm going to open this up for our patient.

    02:53 So then I'm going to take my catheter itself and Y is going to seat in here.

    03:00 So again, here's the Y of our catheter, we're going to see this in just like this, see how that fits nicely.

    03:07 So I'm going to take this clamp, and it's going to be clamped down for a patient, you should hear a bit of a click.

    03:15 So that's what we want to do.

    03:16 So now you can see this can wiggle.

    03:19 And this is nice and secure for our patient.

    03:22 So this is our catheter securement device.

    03:25 Now, I will tell you, you may see some people tape or something like that, the main thing is to help provide some support for our patient's catheter.

    03:34 So this is our catheter securement device.

    03:37 So once we have this affixed, the next thing to think about is how you maintain your catheter.

    03:43 So let me show you a little piece of equipment.

    03:49 This is our green clamp.

    03:51 Some, but you may not always see this being used, it's actually a helpful piece of equipment.

    03:56 So what we're going to do with this is help secure this to the patient's sheets.

    04:01 So what this does is you will take the catheter or excuse me, the clip, you're going to squeeze it, this is going to affixed to the patient's bed linens, for example.

    04:10 So you may see it open with the clamp, like this.

    04:15 So that's just to show you how the clamp works.

    04:18 But our tubing is important to maintain, what I mean by that after insertion, what I don't want to see is what we call a dependent loop or kinks in the line.

    04:31 Right, urine needs to flow.

    04:33 So what I mean by dependent loop is once you hang it, do you see how this U shape occurs, this is what we call a dependent loop.

    04:41 This can be a potential problem and what you need to avoid for your patients.

    04:45 Urine can sit in here and it can back all the way back up to the patient's bladder.

    04:51 We want this nice in draining free and clearly without kinks or dependent loops.

    04:57 So make sure you're cognisant of that when you hang your bag as well.

    05:01 All right, so here's talking about tubing.

    05:04 Next, let's talk about this collection bag itself.

    05:07 There's some important components to know.

    05:10 So this collection bag is really helpful, we've already got a hanger, they all come with this to secure this to the bed.

    05:17 And we'll talk about that piece too.

    05:19 But I want you to see on the bag itself, this is a urinary drainage bag.

    05:24 So you're gonna see some variations to this, you may see some of these that have a like a clear box and extra meter on there.

    05:32 You may see a urinary drainage bag like this, but this is to help us measure our urine.

    05:38 Now, it's really important that you actually drain it to make sure you get the appropriate amount of urine recorded.

    05:45 So just again, show you the mechanisms of the bag.

    05:49 You see here, there's a little bit of a clamp, you can make sure and squeeze this and open this up and drain this to whatever you need to record your urine volume in.

    05:59 There's also a clamp as you see, if you push down, that is going to open it up for urine flow into empty.

    06:07 But make sure anytime you empty it to make sure to clamp this bag, so you're in does not spill out.

    06:15 Then once we're done, this just goes back into this little cap on the bag to keep this clean.

    06:21 So these are some of the components of the bag that's important.

    06:25 One other thing about this bag.

    06:27 So you notice we just inserted this here.

    06:30 You know many times when this come out of the package, there's almost like a vacuum suction that's happening.

    06:36 So to ensure that that the urine in the tubing is going to drain in the bag, break this seal here.

    06:43 So I'm going to take a piece of the outside and a piece of the backing.

    06:47 Make sure that this is just separated, there's no perfect measurement for this.

    06:52 Just make sure it's separated because what we don't want is that to back up into the patient's bladder.

    06:59 So this will help ensure it goes into the collection bag.

    07:03 Then once you've done all of this, you want to fix this to a nonmoving part of the bed.

    07:09 What I mean by this is once we hang this for our patient, you don't want this hanging on the bed rail, for example.

    07:16 So why do we not do this? Well, if you move the bed rail and it's attached to your patient that could cause some tugging, we don't want that.

    07:24 So when you hang this, make sure it's below the level of the patient's bladder.

    07:30 It's also not on a moving part of the bed.

    07:33 So again, below the level of the bladder, and also make sure it's on a nonmoving part of the bed.

    07:41 Then before you leave the room of course return the bed to the lowest position.

    07:44 Dispose of all your used supplies.

    07:47 Remove your gloves, perform hand hygiene, and make sure you document.

    About the Lecture

    The lecture Indwelling (Foley) Urinary Catheter Insertion: Post-procedure (Nursing) by Samantha Rhea, MSN, RN is from the course Indwelling (Foley) Urinary Catheters (Nursing).

    Included Quiz Questions

    1. Upper thigh
    2. Lower thigh
    3. Hip
    4. Groin
    1. To clamp the tubing to the client's bedsheets so the urine drains straight down.
    2. To clamp the catheter during urine specimen collection.
    3. To clamp the tubing to the client's gown to ensure the bag's weight does not pull on the catheter.
    4. To clamp to the catheter securement device to ensure proper placement of the tubing.
    1. Infection
    2. Bladder rupture
    3. Urethral trauma
    4. Pain
    1. At a fixed point on the bed, below the level of the bladder
    2. On the bed rail, below the level of the bladder
    3. On the foot of the bed
    4. The catheter bag can be placed on the mattress and moved around when necessary

    Author of lecture Indwelling (Foley) Urinary Catheter Insertion: Post-procedure (Nursing)

     Samantha Rhea, MSN, RN

    Samantha Rhea, MSN, RN

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