How to Trouble Shoot Urinary Foley Catheters | Nursing Urinary Retention

Hey everyone

In this video I will teach you how to trouble shoot foley catheters. In the emergency department we see a lot of patients with foley catheters, sometimes they do not work and they are sent to the E.R for us to figure out what is going on. In this video I will give you some tips and tricks on how to best trouble shoot a patient who has a foley catheter that is not draining.

Before I being, like I said, I work in the emergency department as a registered nurse. I am not a urologist or a urology nurse specialist, but with that being said, I have been successful in helping quite a bit of people who have problems with their foley catheters and in this video I want to provide other nurses the knowledge to do so as well.

Foley Catheter’s Not Draining:

If your foley catheter is not draining there is obviously a problem. Now this could be caused by many different things. However the first thing you must do is always assess the patient. The patient may present with certain complaint but you need to assess for abdominal distention, tender to palpation and really do a focused assessment. After you’ve done that you need to find objective data to validate that the foley catheter is truly not draining and to do that you need to do a bladder scan. A bladder scan will tell you how much urine is in the bladder and depending on your hospital policy this may warrant another foley insertion. It is generally good to get their bloodwork as well and assess their kidney function via their creatinine and GFR. If there is a significant change from their base line you may want to raise this with the physician at the time. After you’ve done all this and there is an indication to remove the current foley catheter in situ and place another one here are some tricks that I have learned from experience.

1) Look at the bottom of the foley bag and see if you can identify any sediments. Sediments in urine can occlude the foley and can cause it to not work. If that is the case, obviously considering the amount of urine in the patients bladder, try to irrigate the foley with sterile normal saline. This will hopefully disperse the sediments clearing the foley line again.

2) When removing the catheter, look at the catheter tip to identify why there was an occlusion – look for sediments again or sometimes blood clots.

3) Utilize a bigger catheter size. The bigger the catheter the more likely it will drain as there is more surface area that the urine can go through and less likely it is to occlude again.

4) If all else fails, and you cannot figure out why it is not draining the patients bladder, try using a coude tip foley catheter. The coude catheter is specifically designed to maneuver around obstructions or blockages in the urethra. Coude is the French word for “bend” or “elbow,” and coude catheters are slightly bent at the tip which helps them move past a blockage

So there you have it, those are some of the tips I have for trouble shooting foley catheters. If you found this video helpful I would appreciate it if you give the video a thumbs up. Let me know if you have any other tips and tricks for trouble shooting foley catheters I would love to learn from you as well. Thank you so much for watching and I will see you in the next video.

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