Male Indwelling (Foley) Urinary Catheter Removal (Nursing)

00:04 Let's examine male indwelling catheter removal.

00:08 So before we get started, make sure you raise the patient's bed to an appropriate level.

00:13 We want to perform our hand hygiene and we want to don our gloves.

00:17 Now make sure you empty that urine from the drainage bag and record this volume.

00:22 This is important in regards to the patient's intake and output.

00:26 Now to prep the patient, place the absorbent pad beneath the patient's buttocks.

00:31 Now don't forget, let's take a look at all the stuff we're going to need.

00:35 That absorbent pad of course, a 10 mL Luer lock syringe, and also supplies for perineal care.

00:42 To get started with this skill, make sure to perform your hand hygiene and provide privacy.

00:48 Now this next step is crucial.

00:50 Make sure explain the procedure to the patient.

00:53 As you can imagine with someone with an indwelling catheter, there may be some fear, some anxious feelings about getting this removed.

01:00 So take time here and explain this thoroughly.

01:04 We also want to get our patient in the optimal position.

01:07 So as you see here, on this image, there's a male client in a supine position.

01:11 And just a fun trick to remember the patients laying on their back, hands up like they're holding soup, just something that I used to remember this position.

01:20 We also want to make sure to remove the catheter securing device.

01:24 This thing can be on the patient's leg, it can be really uncomfortable to remove.

01:28 So be gentle, be kind here and make sure you remove this device.

01:32 Now we can take that 10 mL syringe to the catheters balloon Luer lock and gently remove the water from the balloon.

01:40 Now this is really important, if you look at this image, notice that we have the plunger and removing it backwards.

01:47 This is going to help remove that water.

01:49 Make sure you take time to get all the water out of the urinary catheter balloon.

01:54 One thing to help with comfort, ask the patient to take a deep breath.

01:58 And while the patient's doing that hold the patient's penis away from the body.

02:03 And as they release the breath, gently remove that catheter.

02:07 Now if you feel resistance, stop and take a pause.

02:11 We don't want to cause trauma to the patient, have the patient relax and try again.

02:17 And after the procedure make sure you provide thorough perineal care.

02:26 Once treatment is complete, let's discuss how we remove an indwelling catheter from our male patient.

02:32 So of course we want to perform our hand hygiene and provide privacy.

02:36 This is really important to explain the procedure to the patient.

02:40 And of course, like all procedures, but I will tell you specifically for the male patient, there could be some anxiousness and some fear that this procedure could be painful.

02:51 Now assure them this should be quick and timely on the removal, it can be slightly uncomfortable, so prepare your patient.

02:58 It should however, not be really painful for your person.

03:02 So again, comfort them, let them know what's ahead.

03:06 So we want to also make sure we assist the patient in a position that's easily accessible for the catheter.

03:11 So most of the time for our male patients, they're going to be in a supine position who where they're laying on their back.

03:18 Now your patient should have a catheter securement device.

03:22 This is really important to prevent excess tugging.

03:25 But before you remove it, go ahead and take this off your patient.

03:29 Typically you're going to find this on your patient's thigh, you can be really kind and use maybe an adhesive remover to loosen up that adhesive off the skin or an alcohol pad.

03:38 But be gentle because this can pull on the patient's skin and a little bit on their hair on their leg.

03:44 So once we've removed the catheter securement device, we can go ahead and get our Luer lock syringe and deflate the balloon.

03:51 So at this point, I've got my patient here, Larry, and I'm going to go ahead and pull back the covers because I'm going to need to support him upon removal.

04:02 "Okay, Larry, I'm just pulling back the covers here so I can get to your catheter." "So you can go ahead just relax. I'm just taking out...

04:13 the water from the balloon." So I'm going to take my 10 mL syringe and this is going to go to the balloon port.

04:20 So luckily, it's one of the only ports that's going to come off besides of course, your urine sample report, but this is the one I'm really going for.

04:28 So I'm going to take my syringe and attach this here.

04:32 Now there may be some built up pressure with the balloon which is good, you can kind of already see this filling.

04:39 We're going to go ahead and assist and pull back on that plunger and we should get at least 10 mLs of syringe of fluid to deflate that balloon.

04:49 There may be more though.

04:52 So now that I pulled back, I'm going to detach and I'm going to go ahead and squirt this out into my trash can.

05:01 So it's really important in especially in our male patients because their urethra is longer that we ensure there's no sterile water in the balloon.

05:12 We want to make sure that's completely deflated before we pull it through the urethra.

05:17 So you see how I pull back my plunger, there's lots of air in here.

05:20 It's a good sign, that means I've gotten all of my water out.

05:23 So I mean, keep that tension and disconnect the syringe.

05:27 Now I can get rid of this.

05:30 Now this is the important step.

05:32 Now I'm going to talk to Larry and instruct him to take a deep breath.

05:35 And then once he relaxes and exhales, that's when I'm going to support him and remove the catheter.

05:42 "Okay, Larry. So let me let you know what's going on.

05:45 I want you to take a deep breath in.

05:48 Once you do that, and you exhale, I'm going to hold you and I'm also going to remove the catheter quickly and gently." "Okay, are you ready?" Okay.

05:57 So let me go ahead and support my patient to make sure their urethra is straight.

06:01 "Okay, Larry, I want you to take a deep breath.

06:03 Okay, on exhalation I'm removing.

06:05 Okay, go ahead and exhale." Okay, so now Larry's exhaling and I'm going to go ahead and punch this in my glove.

06:13 That way I can hold on to the catheter.

06:16 Now if I felt a lot of resistance, I would need to stop.

06:19 So just keep that in mind so you don't cause excess trauma to your patient.

06:24 I'd like to hold this into my glove.

06:26 There's going to be mucus, maybe excess urine in here as well in the catheter.

06:31 So be conscious of this and then dispose of it properly.

06:34 Now after the procedure is complete, make sure you provide thorough perineal care for your patient as well and then lower the bed before you go.