PERFORMING CATHETER AND BLADDER IRRIGATION

ASSESSMENT IMPLEMENTATION

1. Check the patient’s record to determine - Closed Continuous Irrigation

a. Purpose of bladder irrigation 1. Using aseptic technique, insert tip of sterile irrigation
b. Physician’s order tubing into bag containing irrigation solution
c. Type of irrigation solution to be used 2. Closes clamp on tubing and hangs bag solution on IV
d. Frequency of irrigation pole
e. Type of catheter used - triple lumen 3. Opens the flow clamp and flushes the tubing keeping
i. 1 lumen - inflate balloon end of tubing sterile; then closes clamp.
ii. 1 lumen - instill solution 4. Wipes off irrigation port of the triple lumen catheter or
iii. 1 lumen - allow outflow of the urine attaches sterile Y connector to double lumen catheter,
then connects to irrigation tubing.
2. Assess the following - 5. Be sure drainage bag and tubing are securely
a. Color of urine and presence of mucus or connected to drainage port of triple Y connector to
sediment double lumen catheter
b. Patency of drainage tubinf 6. For intermittent flow, clamps tubing on drainage
c. Closed system system, opens clamp on irrigation tubing, and allows
i. Note if fluid entering bladded and prescribed amount of fluid (40/60 drops/min) to enter
fluid draining from bladder are bladder, closes irrigation tubing clamp, then opens
appropriate proportions drainage tubing clamp.
ii. Note amount of fluid remaining in 7. For continous irrigation, calculates drip rate and
existing irrigating solution container adjusts clamp on irrigation tubing accordingly; be sure
iii. Check irrigation solution tubing to clamp on drainage tubing is open and checks volume
ensure it has no kinds and is of drainage in drainage bag.
opened or clamped according to the 8. Re-anchors catheter to patient with tape
physician’s order. 9. Assists client into comfortable position.
10. Lowers bed to lowest position, siderails down if
3. Review patient’s medical record, including physician’s
appropriate.
order.
11. Disposes of contaminated supplies and washes
4. Review I and O record.
hands.

PLANNING
EVALUATION
1. Develops individualized goals of care for patient
based on nursing diagnosis: 1. Calculates fluid used to irrgate bladded and catheter,
a. Maintains patent, free flowing urinary and subtracts from volume drainage.
drainage system 2. Assesses characteristics of output -
b. Minimizes risk of infetion a. Viscosity
c. Minimizes discomfort b. Color
2. Collect necessary equipment and supplies: c. Presence of Clots
a. Closed Continous Method d. Observe catheter patency.
i. Sterile Irrigating solution 3. Recording and Reporting -
ii. Correct ba or solution irrigating a. Record amount of solution used as irrigant,
tubing with clamp (with or without y and amount returned as drainage in inurse
connector) notes, and I and O sheet.
iii. Metric container b. Report catheter occlusion, sudden bleeding,
iv. IV Pole infection, or increase pain to physician.
v. Antiseptic Swab
vi. Y connector
vii. Bath Blanket
viii. Clean glovers
3. Explain the procedure to the patient.