Imagine not having to rush to the bathroom in the middle of the night or worry about wet sheets. For residents who cannot control their bladder or get out of bed, a Foley catheter provides this relief. However, this common medical device requires your vigilant eyes and careful hands to keep your resident safe from infection.
What is a Foley Catheter?
A Foley catheter (indwelling urinary catheter) is a flexible, sterile tube inserted into the bladder to drain urine. It remains inside the body, held in place by a small balloon filled with sterile water at the tip. The tube connects to a drainage bag that collects urine output. This allows for continuous drainage and accurate monitoring of kidney function for residents who are immobilized, incontinent, or recovering from surgery.
Why Foley Catheters Matter in Your Daily Care
While Foley catheters are essential for managing urine output and preventing skin breakdown from wetness, they are also a major risk factor for Urinary Tract Infections (UTIs). Your role is crucial in maintaining a closed drainage system and ensuring the catheter doesn’t cause trauma. Proper care means your resident stays comfortable, dry, and free from the pain and confusion that often accompany a UTI.
What You’ll See During Your Shift
You will see the tubing exiting the urethra (or suprapubic area) and leading down to a collection bag. The bag might hang on the bed frame or be strapped to the resident’s leg for ambulation. You will be responsible for emptying this bag and recording the output. Watch for kinks in the tubing or tugging on the device.
“Nurse, I was emptying Mr. Alvarez’s catheter bag and noticed the urine looks cloudy and has a strong odor. He also seemed more confused during care than usual this morning. The output was only 200ml for the last 4 hours.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Placing the drainage bag above the level of the bladder, such as lifting it onto the bed while making the bed or helping the resident move up. This allows urine to flow back into the bladder, causing infection.
Pro Tip: Always keep the collection bag below the level of the bladder at all times. Gravity is your friend here—let it pull the urine down, never back up. Also, secure the tubing to the resident’s leg with a leg strap to prevent accidental tugging when they move.
Memory Aid for Foley Care
Think “Down and Secure”:
- Down: Keep the bag below the bladder.
- Secure: Tape or strap the tube to the thigh so it doesn’t get pulled.
If you remember to keep gravity working down and the tube secure, you will prevent most common complications.
State Test Connection
Expect questions on the CNA exam regarding Standard Precautions (wearing gloves), maintaining a “closed system” (never disconnecting the tubing), and proper positioning of the drainage bag to prevent reflux.
Related Care Concepts
Mastering Foley care connects directly to Intake and Output (I&O) measurement, which tells you how well the kidneys are working. It also relates to Perineal Care, as keeping the area around the catheter clean prevents infection. Furthermore, you should always be alert for signs of a UTI, such as cloudy urine or fever, which require immediate reporting.
Quick Reference
✓ Key steps: Empty bag before it is full, measure output accurately, clean from meatus outward ✓ When to report: No urine output for 2-4 hours, bloody urine, cloudy urine, foul odor, or pain ✓ Care reminders: • Keep drainage bag below bladder level always • Secure tubing to leg to prevent traction • Maintain a closed sterile system (do not disconnect tubing) • Practice hand hygiene before and after touching the catheter
Caring for a resident with a Foley catheter isn’t just about emptying a bag; it’s about protecting them from infection while preserving their dignity. Your attention to detail here makes a real difference in their comfort and recovery.