Introduction to Inserting a Foley Catheter on a Female Client

A Foley catheter is a medical device that is inserted into the bladder via the urethra to drain urine from the body.

The Foley catheter has many uses in clinical practice, including:

• Draining urine from a full bladder when there are no other options, or there are complications with urination.
• During and after surgical procedures.
• Relieving pressure from the bladder.
• Monitoring urine output while a client is unable to urinate by themselves.

Inserting a Foley catheter into a female client is one of the more challenging procedures in nursing. It is a foundational skill that nursing students must be able to recognize essential concepts and be able to perform competently before becoming a nurse. It requires knowledge, skill, and attention to detail to safely complete the insertion of the catheter.

Foley Catheter Supplies

The supplies you’ll need for a Foley catheter insertion in a female client include:

• A Foley catheter (a flexible tube)
• Antiseptic solution (povidone-iodine)
• Gloves
• Sponge stick
• Tape or agency-approved item (to hold the foley catheter in place)
• Water soluble lubricant 
• A sterile towel or paper sheet (to lay under your client before you insert the catheter)
• Catheter kit with drainage bag (which should contain the majority of the above-needed items)

Complications of Foley Catheter Insertion

The most common complications of Foley catheter insertion are incontinence and increased risk of infection. Other complications include bladder perforation and ureteral injury (during removal of the catheter), as well as bleeding at the puncture site where the catheter entered the bladder (which can lead to severe bleeding).

Bleeding and clotting from Foley catheters can be life-threatening if left untreated. Clotting occurs after insertion and can result in pain or swelling around the urethra.

How to Insert a Catheter in a Female Client

1. Verify the prescription for a catheter and explain the procedure to the client.
2. Ask the client about allergies such as latex, betadine, and any previous genitourinary surgeries.
3. Gather all needed equipment.
4. Wash hands.
5. Ask and assist the client in removing any undergarments prohibiting catheter insertion.
6. Provide privacy while positioning the client in a supine position with hips flexed.
7. Don clean gloves and provide perineal care.
8. Remove gloves and wash hands.
9. Open the sterile catheter kit on a clean surface.
10. Place the sterile drape under the client’s buttocks.
11. Put on sterile gloves.
12. Saturate cotton swabs with povidone-iodine (betadine) or agency-approved cleanser.
13. Lubricate the catheter tip with water-soluble lubricant.
14. Attach the sterile water syringe to the catheter.
15. Separate the labia minora from the non-dominant hand and consider this hand to be contaminated.
16. With the dominant hand, clean the outside of each labium, discarding after use and cleaning the meatus last.
17. Grasp the sterile catheter two to three inches from the tip. Instruct the client to take a deep breath in, and gently insert the catheter into the urethra.
18. Advance two to three inches until urine starts to flow, and then continue for another one to two inches.
19. While holding the catheter in place, inflate the balloon and disconnect the syringe from the port.
20. Pull gently on the catheter until resistance is felt.
21. Secure the catheter in place with tape or an agency-approved item for securing.
22. Document the procedure.