Indwelling Catheter (Foley)
An indwelling catheter (Foley catheter) is a flexible tube inserted through the urethra into the bladder to continuously drain urine. It is held in place by an inflated balloon and connected to a closed drainage system. Proper catheter care is essential to prevent catheter-associated urinary tract infections (CAUTIs).
Exam Tip
Keep drainage bag BELOW bladder level at all times. Never disconnect the closed system. Clean catheter daily with soap and water. Secure catheter to thigh. Assess daily for removal. CAUTI prevention is a top nursing priority and quality measure.
What Is an Indwelling Catheter?
An indwelling urinary catheter, commonly called a Foley catheter, is a sterile tube inserted into the bladder through the urethra for continuous urine drainage. A small balloon at the tip is inflated with sterile water to keep the catheter in place. It is connected to a closed drainage system with a collection bag.
Indications for Indwelling Catheter
| Indication | Example |
|---|---|
| Acute urinary retention | Post-surgical inability to void |
| Accurate I&O monitoring | Critical care, hemodynamic instability |
| Perioperative use | Lengthy surgical procedures |
| Open wounds in sacral/perineal area | Stage 3-4 pressure injuries |
| Patient comfort | End-of-life care (per patient/family wishes) |
| Prolonged immobilization | Unstable spine, multiple fractures |
Catheter Care (CAUTI Prevention)
| Nursing Intervention | Rationale |
|---|---|
| Perform hand hygiene before and after catheter care | Prevents introduction of bacteria |
| Clean perineal area and catheter with soap and water daily | Removes secretions and bacteria |
| Keep drainage bag BELOW bladder level | Prevents urine backflow |
| Keep tubing free of kinks and loops | Ensures gravity drainage |
| Never disconnect the closed system unnecessarily | Prevents bacterial entry |
| Empty bag regularly (when 2/3 full) | Prevents backflow and bag weight pulling on catheter |
| Secure catheter to thigh or abdomen | Prevents traction and urethral trauma |
| Assess for removal daily | Shortest duration possible reduces CAUTI risk |
Signs of CAUTI
- Fever, chills
- Cloudy, foul-smelling urine
- Flank or suprapubic pain
- New onset confusion (especially in elderly)
- Elevated WBC count
Exam Alert
Catheter care questions appear in the Safety and Infection Control and Basic Care & Comfort categories on the NCLEX-PN. Key rules: keep the bag below the bladder, maintain a closed drainage system, clean daily, and advocate for earliest removal. Know CAUTI prevention as it is a hospital-acquired infection (HAI) quality measure.
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Related Terms
Standard Precautions (Nursing)
Standard precautions are a set of infection control practices used with ALL patients regardless of diagnosis or infection status. They include hand hygiene, use of personal protective equipment (PPE), safe injection practices, respiratory hygiene, and proper handling of contaminated equipment and surfaces.
Intake and Output (I&O)
Intake and Output (I&O) is a nursing measurement that tracks all fluids entering (intake) and leaving (output) a patient's body over a specified period, typically 24 hours. Accurate I&O monitoring is essential for assessing fluid balance, kidney function, and hydration status.
Scope of Practice (Nursing)
Scope of practice defines the legal boundaries of what a healthcare professional is authorized to do based on their education, licensure, and state Nurse Practice Act. For LPNs/LVNs, the scope includes basic nursing care, data collection, medication administration, and care plan implementation under RN or physician supervision.
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