As you begin your morning rounds, you notice a drainage bag attached to the bed rail of Mr. Henderson, who is recovering from surgery. This setup includes an indwelling catheter, a common medical device that requires your specific attention to ensure his safety and comfort.
What is an Indwelling Catheter?
An indwelling catheter (often called a Foley catheter) is a flexible tube inserted through the urethra into the bladder to drain urine. It remains inside the body and is held in place by a small balloon inflated with sterile water at the tip. The tube connects to a drainage bag that collects urine output. This allows for accurate measurement of kidney function and is used for residents who cannot control their bladder or need strict fluid monitoring.
Why Indwelling Catheter Matters in Your Daily Care
Proper management of an indwelling catheter is one of your most important defenses against Urinary Tract Infections (UTIs). Because the tube creates a direct path into the bladder, bacteria can easily enter if the equipment isn’t handled correctly. Your role in keeping the system closed and clean is vital. Furthermore, ensuring the bag is positioned correctly protects the resident from painful trauma and keeps urine flowing freely, preventing bladder distension or kidney damage.
What You’ll See During Your Shift
You will interact with this device during perineal care, toileting assistance, and output documentation. You’ll check the urine for color, clarity, and odor, and ensure the tubing isn’t kinked or dragging on the floor.
“Nurse Jen, I was doing Mr. Henderson’s perineal care and noticed the urine in his catheter bag looks cloudy and has a strong odor. He also seems a little warm to the touch. I’ve secured the tubing to his leg so it doesn’t tug, but I wanted you to take a look.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Placing the drainage bag above the level of the bladder. If the bag sits on the bed or is lifted while transferring the resident, urine can flow back into the bladder, causing infection.
Pro Tip: Always secure the catheter tubing to the resident’s inner thigh using a leg strap or tape. This prevents the catheter from being pulled or tugged, which can cause pain and tissue damage, and keeps the tubing from getting caught during transfers.
Memory Aid for Indwelling Catheter
Think “Bag Below Belly.”
The drainage bag must always be lower than the resident’s bladder (belly button). Gravity helps urine drain down and out; if the bag goes up, infection flows back in.
State Test Connection
Expect questions on the state exam regarding infection control procedures, specifically keeping the drainage system closed and sterile, and the critical rule of always keeping the collection bag below bladder level.
Related Care Concepts
Caring for an indwelling catheter goes hand-in-hand with perineal care to prevent infection at the insertion site. It is also a primary component of intake and output (I&O) monitoring, which helps the care team assess fluid balance. Additionally, you must be vigilant about skin integrity, keeping the area dry to prevent moisture-associated skin damage.
Quick Reference
✓ Key checks: Ensure urine is flowing freely (no kinks), color is pale yellow/straw-colored, and bag is below bladder level ✓ When to report: No urine output for 2-4 hours, blood in the urine (hematuria), or signs of infection (cloudy urine, fever, foul odor) ✓ Care reminders: • Always keep the drainage bag below the level of the bladder • Secure the tubing to the leg to prevent traction • Clean the meatus (insertion site) from front to back during perineal care • Empty the drainage bag regularly using a separate measuring container
Bottom line: Your careful management of the catheter system protects your resident from painful infections and ensures accurate health monitoring. That is essential, compassionate care.