BLADDER IRRIGATION

BLADDER IRRIGATION

Bladder irrigation or wash is defined as washing of the urinary bladder by directly a stream of solution into the bladder through the urinary meatus by means of a catheter tubing and funnel

Purpose

• To cleanse the bladder from decomposed urine bacteria, excess mucus and pus
• To medicate the lining of the bladder of antiseptic irrigation
• To prepare the bladder for surgery as a preoperative measure
• To promote healing
• To relieve congestion and pain in case of inflammatory conditions of cystitis
• To arrest bleeding and prevent clothing of blood

Solution Used

• Normal saline 0.9%
• Boric acid solution 2%
• Sterile water
• Acetic acid 1:4000 to treat pseudomonas infection
• Sodium nitrate 1:8000 to prevent clot formation
• KMO₄ 1:5000 – 1:10,000
• Acriflavin 1:10,000
• Silver nitrate 1:5,000
• Mercury compounds in low concentration

General Instructions

• The temperature of the solution needed for cleaning purpose body temperature in enough
• The temperature of the solution needed for therapeutic purposes ranging from 100-110 degree F
• The maximum amount of solution used for cleaning is 2 pints and also depends on the patient’s condition

Methods of Administration

• Funnel and tubing method (open method)
• Irrigation can, rubber tubing and Y connection
• Asepto syringe (open method)

Preliminary Assessment

Check

• Doctors order for specific precautions and instructions
• General condition of the patient
• Diagnosis of the patient
• Self care ability of the patient
• Mental status to follow instructions
• Articles available in the unit

Preparation of the Patient and Environment

• Explain the sequence of the procedure
• Arrange the articles at the bed side
• Provide privacy
• Place the patient in comfortable position
• Place the Mackintosh under the buttocks

Equipment

Sterile Catheterization Pack

A sterile tray containing:

• Funnel, tubing 3 feet long which fits the connection screw clip and glass connection
• A small mug or pint measures to pour solution
• A sterile pint jug with required solution
• Solution thermometer kept in antiseptic solution in a bottle if available
• Medication if ordered
• Bucket for emptying the return flow
• Litmus paper

Procedure

• Wash hands thoroughly
• Wear gloves and empty the bladder keeping outlet of catheter uncontaminated
• After urine withdrawal, attach glass, connection, tubing and funnel to the catheter
• Place bucket or kidney tray conveniently near the meatus
• Hold the funnel lowered with one hand and with other hand pour 75-100 ml of solution along sides of the funnel
• Raise the tube and keep the funnel 30 cm above bed level
• Never allow the funnel to be empty, lower the funnel and slowly invert in over the bucket
• Repeat procedure until the return flow is clear
• At the end of the procedure, clamp tubing disconnects glass connection, tubing and funnel, gently remove catheter and complete
• In case of self-retaining catheter connect it to the drainage bag

After Care

• Provide catheter care
• Remove the Mackintosh and position the patient comfortably
• Cover the patient with bed sheets
• Replace the articles after cleaning
• Wash hand thoroughly
• Record the procedure and observations in the nurse’s record sheet