FOLEY INSERTION/REMOVAL – JUNE 12, 2025 @ 23:40



Indwelling Urinary Catheter

Is the patient allergic to?

Latex

NO

Povidone iodine

NO

Were alternatives to indwelling urinary catheters considered prior to

insertion? Yes

Is there an order for insertion?

Yes

Indication for insertion

Acute urinary retention or bladder outlet obstruction

2nd Verifier: TRISH RN

Time Inserted: 2340PM

Date Inserted

Date: June 12, 2025

Scheduled Replacement

Pre-insertion care

Bladder scan completed prior to insertion

Result: 652 ML

Peri-care performed

Hand hygiene performed

Yes

Insertion care

Sterile peri-urethral cleaning performed

Balloon inflation amount: 10 ML

Any resistance noted?

No

Urine return noted?

YES

Output: 150ml

Urine Character

cloudy, hazy

Material of Foley

Silastic

Type of Foley

Straight

Catheter size (Fr)

16

Tamper seal intact?

Yes

Patient tolerated procedure well?

Yes

Immediate post-insertion care

Catheter properly secured to patient

Position drainage bag below the bladder

Maintain a closed drainage system

Education provided on

Click here for FAQs Catheter Associated Urinary Tract Infection

-indication for use

-importance of securing catheter

-maintaining closed system

-keeping bag below the bladder

-catheter care

-symptoms of CAUTI (fever, chills, new confusion/weakness, new lower

abdominal/flank/testicular/prostate pain, or discharge (pus) around

catheter)

PATIENT/FAMILY EDUCATION: Level of understanding: Good

✍️ Verified Electronically: IRENE BINGCANG, RN

STAFF NURSE

📅 Signed: 06/17/2025 19:09

Receipt Acknowledged By

06/17/2025 19: 13 /es/ ROSBEL IVY AMBAAN

BSN RN