How to Care for Your Foley Catheter

GENERAL INFORMATION:

What is it? A Foley catheter is a thin rubber tube which is put into your bladder (organ that holds urine). It is used to drain urine out of your body. A Foley catheter is also called an "indwelling catheter". After the catheter is inserted, its tiny tip can be inflated (filled) with sterile (clean) water to make a small balloon. The balloon holds the Foley in place and keeps it from slipping out of your bladder. A Foley catheter can stay in the bladder for a short or long time.

How is a Foley catheter put into my bladder? A caregiver will usually put the catheter in for you. You will lie down on a bed with your legs spread apart. Your caregiver will use special soap to clean the skin around your urinary meatus. The urinary meatus is the opening where your urine comes out. The caregiver will put the Foley into your urinary meatus and gently push it into your urethra. When the catheter reaches your bladder, the caregiver will inflate the catheter tip. Your catheter will be connected to a sterile (clean) bag, which will collect your urine. You may have a small leg bag or a larger bag that is attached to your bed or clothing.

Daily Care: Follow these steps every day. These will help prevent a bladder or kidney infection and will keep you more comfortable.

• Always wash your hands before and after doing catheter care. Use soap and warm water.
  
   
• Keep your skin and catheter clean. Clean the skin around your catheter at least once each day. Clean your skin area and catheter after every bowel movement (BM).
  
   
• Always keep your urine bag below the level of your bladder. This is at about the level of your waist. Keeping the bag below this level will prevent urine from flowing back into your bladder from the tubing and urine bag. Backflow of urine can cause an infection.
  
   
• Wear cotton underwear. This will allow good air flow and drying in your genital area.
  
   
• Drink plenty of liquids. Drink at least 8 cups of healthy liquids each day. Follow your caregiver's advice if you must change the amount of liquid you drink. For most people, healthy liquids to drink are water, juices, and milk. Limit the amount of caffeine in your diet. Caffeine may make you urinate too much and lose too much body fluid. Caffeine may be found in coffee, tea, soda pop, and sports drinks and foods. Try to drink enough liquid each day, and not just when you feel thirsty.
  
   
• Do not tug or pull on the tubing. This can cause bleeding and hurt your urethra. Do not step on the tubing when walking. Hold the tubing curled in your hand with the urine bag below your bladder when walking. You may also want to clip or pin the tubing to your clothing.
  
   
• Place the catheter tubing so it does not kink or loop. When getting into bed, hang the urine bag beside the bed. Make sure the bag is below the level of your bladder. If you use movable bed rails, do not hand the urine bag on the bed rail. Hang the bag on the frame of the bed instead.

Checklist for cleaning your skin and catheter:

• __ 1. Gather your supplies.
  
   
  • Bowl or container to collect urine.
    
     
  • Bowl of warm water, soap, washcloth, and hand towel.
    
     
  • Waterproof pad or bath towel.
  
   
• __ 2. Wash your hands. Use warm water and soap before and after doing your catheter care.
  
   
• __ 3. Clean the skin around your catheter.
  
   
  • First, use a clean washcloth, warm water, and soap to gently wash the urinary meatus. Wash in a circle-like motion, moving away from the meatus. This helps prevent germs from being moved from the anus (rear end) into the urethra.
    
     
  • Hold the end of the catheter tube to keep it from being pulled while cleaning. Wash around the catheter to remove any blood, crust, or mucus.
    
     
  • Always wash the area around your anus last. Put the wash cloth into the laundry and do not use it again until it has been washed. Rinse and pat dry your genital area and catheter with a clean towel.
  
   
• __ 4. Secure the catheter and bag. Tape the catheter to your thigh (upper leg). This will prevent the catheter from tugging and possibly being pulled out. If you are in the hospital or are using an overnight bag, use a safety pin to fasten the catheter to the bed sheet or your gown. Make sure the safety pin goes around the catheter tube and not through it. The drainage bag may have hooks to fasten to your bed frame. Do not put the bag on the floor. Leave some slack in the tube so the catheter will not be pulled when you move your leg. If you use a leg bag, tape it to your skin. A leg strap can be used instead of tape. This may help prevent skin problems or sore areas.

Caring for your Foley or leg drainage bag:

• Catheters are made to be closed drainage systems. This means that the path from the tip of the catheter inserted into the bladder, to the bag which catches urine, is closed. A closed system decreases the chance of getting an infection. It also decreases the chance of the catheter breaking and urine spilling out. People with catheters and their caregivers should avoid detaching parts of the catheter along the closed system unless it is necessary.
  
   
• Larger, sterile, drainable, two liter drainage bags or smaller sterile leg bags are used to collect your urine. To keep a closed system, these bags are connected directly to the catheter. If you use a leg bag to collect urine, a larger drainage bag may be attached at night with a special connector. Some plastic drainage bags should be changed every 5 to 7 days. Ask your caregiver how often your drainage bag should be changed.
  
   
• Drainage bags must be kept below the level of the bladder. This will allow gravity to help drain the urine, and will stop urine from flowing back into your bladder. Urine that flows back into your bladder increases your risk of an infection. Do not let the drainage bag rest on or touch the floor. The tubing that goes from your urethra to a leg bag should be secured to your thigh with special tape, a leg strap, or a drain tube stabilizer. Allow extra tubing between the urethra and the point where the tubing is secured to your thigh.

Emptying your Foley or leg drainage bag: A drainage bag should be emptied only when it is full enough that this is needed. Empty full-sized bags every eight hours, and smaller (leg) bags every 3 to 4 hours, or when they are full. The following are steps to be used when emptying your drainage bag:

• Place a large plastic or metal container on the floor next to you, or you may empty the urine into the toilet.
  
   
• Wash your hands with soap and water.
  
   
• Without touching its tip, remove the drain spout from its sleeve at the bottom of the urine bag. Open the slide valve on the spout.
  
   
• Let the urine flow out of the urine bag into the container or toilet. Do not let the drainage tube touch anything.
  
   
• When the bag is empty, clean the end of the drain spout with water and tissue. Close the slide valve and put the drain spout into its sleeve at the bottom of the urine bag.
  
   
• Wash your hands with soap and water.
  
   
• Write down how much urine was in your bag if caregivers have asked you to keep a record.

Cleaning your Foley or leg drainage bag:

• Get a new or cleaned urine bag with tubing.
  
   
• Wash your hands with soap and water.
  
   
• Put a clamp on your Foley catheter tubing near the connection to the urine bag tube. Unhook the old bag and hook the Foley catheter to the new bag. Un-clamp the Foley catheter tubing.
  
   
• Rinse the old bag with warm water.
  
   
• Fill the bag with two parts white vinegar to three parts tap water. Leave the water and vinegar mixture in the bag for at least 20 minutes. You may use chlorine bleach instead of the vinegar and water solution.
  
   
• Empty and rinse the bag. Hang it upside down and let it air dry.
  
   
• When the bag is dry, store it in a clean plastic bag until you are ready to use it again.

Reconnecting your Foley or leg drainage bag:

• Wash your hands with soap and water.
  
   
• Use alcohol or another solution suggested by your caregiver to clean the catheter and drainage bag ends. Attach them back together.
  
   
• Wash your hands with soap and water.

Fixing catheter problems:

• If your catheter is not draining:
  
   
  • Check for kinks. See if the urine tubing is twisted or bent.
    
     
  • See if you are lying on the catheter or tubing.
    
     
  • Make sure the urine bag is below the level of your bladder (waist level).
    
     
  • Change your position and separate your thighs (upper legs).
    
     
  • Irrigate (flush) the catheter if you have been taught how to irrigate catheters.
  
   
• If your catheter comes out or is leaking:
  
   
  • Place a towel or waterproof pad under you to protect your furniture if your catheter leaks or comes out. Do not try to put the catheter back in unless you have been taught how to insert a Foley catheter.
    
     
  • Look for these signs of leaking:
    
     
    • The level of urine in the bag has stopped rising, and no urine has drained from the catheter in 6 to 8 hours.
      
       
    • Your bed or clothes are wet with urine.

Call your caregiver if:

• You cannot get your catheter to drain urine into the bag.
  
   
• Your catheter comes out or it is leaking.
  
   
• Your urine is thick and cloudy. Your urine has mucus, red specks, or blood in it. Urine with blood in it may appear pink or red.
  
   
• Your urine has a strong (bad) smell.
  
   
• No urine has drained from your catheter in 6 to 8 hours.
  
   
• You have pain or burning in your urethra, bladder, abdomen, or lower back.
  
   
• You have shaking chills or your temperature is over 101° F (38.3° C).

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about using a Foley catheter. You can then discuss choices with your caregivers. Work with them to decide what choices may be best for you. You always have the right to refuse and make your own decisions.

Copyright (c) 2007 Thomson MICROMEDEX. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. The information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Additionally, the manufacture and distribution of herbal substances are not regulated in the United States, and no quality standards currently exist. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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