Introduction of a solution into the bladder through a bladder catheter, already in place, and verification of its evacuation.
Objectives:
– Maintain or restore patency of the catheter. – Clean the bladder or apply an antiseptic solution on the bladder mucosa. – Remove bladder clots.
Equipment:
– Graduated collection container. – Trough. – Kocher forceps. – Catheter plugs. – Sterile drape. – Serum holder.
Material:
– Prescribed solution for irrigation. – 1 Syringe of 50 c.c. sterile. – Antiseptic solution. – Sterile gauze. – Sterile gloves, mask, gown and cap. – Soaker. – Nursing records.
Procedure:
– Perform hand washing. – Prepare material. – Preserve the patient’s privacy. – Inform the patient of the procedure. – Ask the patient and family to cooperate. – Place the patient in supine position. – Put on disposable gloves. – Empty, measure and record the amount and appearance of urine in the drainage bag. Discard urine and gloves. – Place soaker under the junction area of the drainage system. – Place sterile drapes and place sterile material on them. – Put on gown, mask, sterile gloves and cap.
1. Intermittent lavage with closed system: 3-way bladder catheter required. Clean the connection area between the catheter and the lavage system with antiseptic and connect. Unclamp the flushing system and regulate the infusion rate. After entering about 100 ml of liquid or as prescribed, clamp again. Keep the liquid in the bladder for a few minutes (10 min). Evacuate the liquid through the drainage system and repeat several times. Perform balance of inflow and outflow and drainage characteristics.
2. Continuous lavage with closed system: 3-way bladder catheter is required. Clean the connection area with antiseptic and connect. Unclamp flushing system and calculate irrigation rate (normal 40-60 drops/min). Perform balance and check characteristics of the drained fluid.
3. Catheter flushing with open system: Two-way bladder catheter is required. Clean the connection area with antiseptic. Clamp catheter with Kocher forceps. Load syringe with 50 c.c. of irrigation solution and connect to catheter. Unclamp and gently inject all the liquid. – To evacuate the fluid can be done through two options: through the drainage bag or slow aspiration through the syringe. – Take stock and observe the characteristics of the drained fluid. – Collect the material. – Leave the patient in a comfortable position. – Remove gloves. – Perform hand washing.
– Record in the nursing documentation the procedure performed, reason, date and time, incidences and patient’s response.
Observations:
– The closed method is the technique of choice for bladder or catheter irrigation because it is associated with a lower risk of infection. Occasionally, open irrigation may be necessary to re-establish catheter patency. In these cases, strict precautions must be taken to maintain the sterility of the drainage tube connection and the inside of the tube. – Whenever the patient reports pain, possible obstruction of the tube should be assessed. – The irrigation solution should always be at room temperature. – Sterile technique in all types of lavages. – Increase fluid intake (if not contraindicated) to ensure normal renal function and avoid tube obstruction. – Communicate to the physician: catheter occlusion, bleeding, pain, abdominal distension or spasms.
Comments