Catheter Foley

Disruption of host defenses owing to intravenous catheters, indwelling Foley catheters, burns, trauma, surgery, and increased gastric pH (secondary to antacids, H2 blockers, and proton pump inhibitors) may place patients at higher risk for infection. Breaks in and entry into the skin provide a route for infection because the natural barrier of the skin is disrupted. Increased gastric pH can allow for bacterial overgrowth and has been associated with an increased risk of pneumonia.18... 

A 43-year-old male in the surgical ICU after exploratory laparotomy following a motor vehicle accident develops fever that is unresponsive to broad-spectrum antibacterial therapy (piperacillin-tazobactam 3.75 g every 6 hours, gentamicin 120 mg every 8 hours, and vancomycin 1 g every 12 hours). The patient has a central venous catheter and a Foley catheter. Blood cultures are negative at the time, but the patient has yeast growing in the sputum and urine. Laboratory studies reveal a white blood cell count of 11,300 cells/mm3 (11.3 x 109/L). 

A urine culture in an asymptomatic female patient with an indwelling Foley catheter comes back with more than 50,000 colonies of enterococci. The urinalysis is unremarkable. The best course of action would be to... 

D) Discontinue use of the Foley catheter if possible and obtain follow-up cultures if she develops symptoms... 

With a chronic indwelling Foley catheter, he most likely has urosepsis. 

Prior to initiation of hypothermia insert a Foley catheter for bladder temperature monitoring. 

Asymptomatic disease Generally no therapy is required Symptomatic or high-risk patierds Removal of urinaiy tract instruments, stents, and Foley catheters) plus 7-14 days therapy with fluconazole 200 mg orally daily or amphotericin BIV 0.3-1 m k day... 

Perineum, rectum, and vagina Assess for contusions, hematomas, lacerations, and bleeding. Perform a rectal exam prior to placing a Foley catheter. A gynecologic exam should be performed. Perineal, rectal, and vaginal injuries may be the result of pelvic injuries. 

A 70-year-old man with advanced obstructive nephropathy began to hemorrhage from the bladder after decompression with a Foley catheter (74). He developed an encephalopathy after continuous irrigation with 1% alum for 2 days, associated with raised serum aluminium concentrations. Repeated treatment with deferoxamine and hemodialysis removed some aluminium, but he succumbed to bronchopneumonia. At autopsy his brain aluminium content was not excessive. 

Cervical ripening is also accomplished in nonpharmacologic ways such as slow dilation of the cervix with an intracervical Foley catheter balloon or with laminaria tents. The laminaria are composed of seaweed and, as they absorb the fluid from the vagina and surrounding tissues, slowly expand over time. They are used more commonly in preparing the cervix for abortion than induction of labor. Acupuncture also has been cited in both cervical ripening and labor induction. 

There are a number of nonpharmacologic methods for cervical ripening. Castor oil, hot baths, sexual intercourse, and nipple stimulation all have been recommended for labor induction. However, there is minimal evidence to support the efficacy of these methods. The use of a Foley catheter placed in an unfavorable cervix for ripening has been found as effective as prostaglandin E2. A safe and inexpensive method, membrane stripping, is particularly of value. ... 

A Foley catheter is required for patients with colorectal carcinoma and lymphoma, for voiding urine. 

Foley catheter finger counting fever, chills flare and cells foam and condom Foley catheter... 

Do not insert Foley catheter or nasogastric tube unless ordered... 

No foley catheter, nasogastric tube, arterial catheter or central venous catheter for 24 h, unless absolutely necessary. 

The nurse is preparing to insert an 18-gauge indwelling urinary (Foley) catheter in a client who has a latex allergy. Which intervention is most important for the nurse to implement ... 

Insert a 16-gauge Foley catheter into the client. 

The most important intervention is for the cKent to have a latex-free Foley catheter because this will stay in the client for an extended period. 

The primary nurse attaches a urometer to the client s Foley catheter. 

A urometer is a plastic triangular container that can be attached to a Foley catheter and allows the nurse to obtain hourly urinary outputs. This action would not require intervention by the charge nurse. 

F. In seriously ill patients (eg, those who are hypotensive, obtunded, convulsing, or comatose), place a Foley catheter in the bladder, obtain urine for routine and toxicologic testing, and measure hourly urine output. 

A. Some adverse effects include dry mouth, blurred vision, cycloplegia, mydriasis, palpitations, tachycardia, aggravation of angina, and constipation. Urinary retention is common, and a Foley catheter may be needed. Duration of effects may be prolonged (several hours). Additionally, CNS anticholinergic toxicity (delirium) may occur with large doses of atropine needed to treat cholinesterase inhibitor poisoning. 

Fluoroscopic Foley catheter removal has a high (91%) success rate with coins that have been in place for less than 3 days. The rate of successful removal is lower with coins that have been lodged for a longer time period (Schunk et al. 1994). The success rate is... 

Patients for fluoroscopic removal should not be sedated in order to maintain their airway. However, patients must be restrained and placed in the prone oblique position. A Foley catheter size 8-12 is placed through the nose or mouth under fluoroscopy to below the foreign body. The balloon is then inflated with 3-5 ml of contrast medium, taking care not to over distend the esophagus. The catheter is gently... 

Schlesinger AE, Parker BP in Kuhn JP, Slovis TL, Haller JO (eds) (2004) Caffey s pediatric diagnostic imaging, 10th edn. Mosby, Philadelphia, pp 1539-1583 Schunk JE, Harrison MA, Cornell HM, Nixon GW (1994) Fluoroscopic Foley catheter removal of esophageal foreign bodies in children experience with 415 episodes. Pediatrics 94 709-714... 

A balloon catheter is placed per rectum (10 F-18 F). Many operators inflate the balloon on the Foley catheter but this is not universal practice and caution should be used when inflating a balloon catheter in the rectum because of the reported risk of mucosal ischaemia. The buttocks are subsequently taped or gripped firmly to complete a good seal at the anus. Air is then introduced into the distal colon, with a manometer or other monitoring device present on the system to ensure safe and constant pressures of air. The progress of the air (and the reduction of the intussusceptum) is closely observed under fluoroscopic guidance (Fig. 6.8a). It is usual practice to include the whole abdomen within the field of view so as not to miss a perfora-... 

However, crosslinked silicone rubber is used so widely in catheters that other problems are more common than one might expeet. For example, Foley catheters are used for urinary drainage in patients and, if the tube breaks, serious problems can follow for the patient (Fig. 9.32). The catheter is more... 

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