Performing a Bladder Irrigation - Definition, purpose and nursing procedure

Performing a Bladder Irrigation - A Simple Nursing Guide.

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Definition:

It is defined as flushing out/washing out the urinary bladder with specified solution.

Purpose:

1. To flush clots and debris out of the catheter and Bladder.

2. To instill medication to bladder lining.

3. To restore patency of the catheter.

Articles:

1. Disposable gloves.

2. Disposable, water resistant, sterile towel/mackintosh.

3. 3 - way retention catheter in situ.

4. Sterile drainage tubing and bag in place.

5. Sterile antiseptic swab.

6. Sterile receptacle.

7. Sterile irrigating solution warmed or at room temperature

  A. Normal saline.

  B. Distilled water.

  C. Solution as prescribed by physician.

8. Infusion tubing.

9. IV pole.

10. Kidney basin.

Procedures:

Nursing Action	Rationale
1. Check physician’s order and nursing care plan for type, amount and strength of irrigating fluid and reason for irrigation
2. Prepare the patient. A. Explain the procedure and its purpose to the patient. B. Provide for privacy and drape the patient. C. Empty, measure and record the amount and appearance of urine present in the urine bag.	A. Clear explanation reduces anxiety. C. Emptying the bag allows for more accurate measurement of urinary output after irrigation.Assessment of character of urine helps in obtaining a baseline assessment data for later comparison.
3. Prepare the equipments. A. Wash hands. B. Connect the irrigation infusion tubing to the irrigating solution and flush the tubing with solution. C. Connect the irrigation tube to the input of 3-way catheter. Connect the drainage bag and tubing to the urinary drainage part if not already in place.	A. Reduces transmission of micro-organisms. B. Flushing the tubing removes air and prevents it from being instilled into the bladder.
4. Irrigate bladder. A. Intermittent Irrigation. a. Instill the prescribed amount of irrigant. If specific amount is not ordered, fill up to 150 ml of irrigant. b. Clamp the irrigant tubing. c. If the physician has ordered the irrigant remain in the bladder, for a measured length of time, clamp the drainage tube and wait for the prescribed length of time. d. Open the drainage tube (the clump) and monitor the drainage as it flows into the drainage bag. B. Continuous Bladder Irrigation. a. Adjust the clump on the irrigation tube to allow the prescribed rate of irrigant to flow into the catheter and bladder. b. Monitor to colour, clarity, debris and volume as it flows back into the drainage bag.	a. The bladder normally feels full when it contains 300 ml of urine. b. Prevents further instillation of irrigant. c. Some irrigation solution contain medication and are meant to remain in contact with the bladder wall for a prescribed length of time. d. Assess the drainage for volume, colour, clarity and the presence of any clots or debris. a. Regulates the amount of irrigant flowing in and out of the bladder to prevent distention or damage to any surgical site. b. Assess for bleeding, clotting and blockage of urine drainage or other complications.
5. Tape the catheter securely to the thigh.	Prevents the catheter from dislodging.
6. Assess the patient’s condition and tolerance of procedure.
7. Discard all used disposable articles, clean and replace reusable articles.
8. Wash Hands.	Prevents spread of microorganisms.
9. Record procedure in Nurse’s Record.

AUTHOR: POOJA YADAV

performing bladder irrigation - nursing procedure

TYPES OF URINARY CATHETERIZATION - NURSING PROCEDURE