Post-Pull Pathyway
How long after a foley pull is a patient DTV?
4-6 hours
How long can a foley stay in place prior to being replaced?
30 days. The foley bag should have the date and time of insertion written on it.
If you are sending a UA from a foley, what should you also be sending?
Reflex UCx
How often should you perform CHG foley care?
q-shift and after every BM
How many RN's need to be present for a foley placement? Where do you document this?
Foley placement is a 2 RN procedure! You document this when creating the LDA.
Your patient spontaneously voided 325cc post foley pull. You scan their bladder and the PVR is 25cc. What do you do next?
No further intervention necessary!
Name an indication for a foley?
24 hours Postoperative
Obstruction
Retention
Need for accurate measurements of urinary output in critically ill patients for which urine cannot be measured in another way.
Chronic indwelling urinary catheter.
Urologic/gynecologic/perineal procedure performed. Patients who require prolonged immobilization (e.g., uncleared thoracic or lumbar spine).
Continuous bladder irrigation (CBI).
To improve comfort for end of life care.
How do you obtain a urine sample from a foley?
Otherwise: from the blue sample port
Your foley is leaking! What do you do?
Discuss removal and remove it able.
Scan bladder to assess for obstruction.
Assess for constipation.
Where should the drainage bag be placed? What should we aboud hanging it on?
Below the level of the bladder and hooked to something secure! Avoid hanging it on the side rail or anything that can be pulled or moved (leg handle of chair)
Your patient voids 150cc 6hours after the foley was removed. The PVR is 450cc. What would you do?
Intermittent straight cath & inform provider
Why do you need a graduated cylinder to empty a foley instead of a urinal?
Larger surface area, less risk for contamination.
If a foley has been in place for 8 days and you have a TRUE indication to send a UA/UCx what do you have to do first?
You suspect your patients foley is occluded, what do you do?
Remove and replace the foley. Irrigation of foleys is strongly discouraged.
What are the different types of securement devices?
Velcro leg strap or adhesive securement
Per the post-pull pathway, how long can you intermittent straight cath a patient before you consider the void trial as failed?
24 hours
Why is a securement device needed?
Prevents tension on the foley. Increased tension increases risk for infection.
What is NOT an indication for UA? (hint: Erika gets heated about this often)
Isolated elevated leukocytosis
How often should our patients with foley's be bathed?
Once a day! (trick question... every patient on our floor should be bathed once a day!)
What medication do we often give in 3 doses prior to foley removal in patients who have issues with retention or BPH?
Tamsulosin (Flomax)
24 hours
How often should your patients foley be emptied?
When the bag reaches 400cc or at least every 8 hours and prior to transport.
What are some reasons that the red seal will not be intact or present?
Urology team inserted, if we are flushing/irrigating the foley (hopefully we aren't), or if we use a different type of catheter such as a coude tip catheter