Nurses Procedure – How to Carry Out Bladder Wash Out and Irrigation

The following procedure are used by professional nurses or student nurses during training in hospitals and clinics to carry our bladder wash out and irrigation for their patients.

BLADDER WASH OUT/IRRIGATION

If the catheter is not already in position, the trolley is set for catheterization.

Extra requirements needed for bladder wash out.

Requirements on a trolley:

Top Shelf:

–     Dressing bowl containing-gauze, Cotton wool swab two dressing towels

–     An instrument tray with: bladder syringes, 2 pairs dressing forceps A pair of dressing forceps

–     Galipot for dressing lotion

–     Kidney receiver with a pair of sterile gloves (if necessary)

–     A litre jug containing       normal saline

–     Sodium citrate or any other prescribed lotion, temperature 100oF (37.7oC)

Tray Containing:

Bottle of hibitane 1:200

Lotion thermometer in jar of hibitane 1:200

Kidney receiver with

Strapping,

Safety pin,

Scissors

Infusion set.

Rail of Trolley:

–     Treatment plastic

–     Salvage bowl

–     Kidney receiver

METHOD:

–     Explain procedure to patient Wash and dry hands

–     Take trolley to patient’s bedside Screen the bed

–     Place patient in dorsal position arranging the treatment plastic under the buttocks.

–     If catheter is not in position, pass catheter in usual way.  Place a sterile receiver between the legs

–     Fill syringe with lotion from the litre jug and expel air

–     Gently introduce about 60cc of fluid to siphon back into the kidney receiver.

–     Disconnect syringing until the returned fluid is clear.

–       Dress supra public wound if any.

–     Clean off discharge from the urethral catheter

–     Wrap gauze dressing around catheter

–     Fasten catheter to the thigh with a piece of Elastoplasts allowing a small loop to prevent pulling.

–     Connect sterile disposal urine bag to catheter

–     Remove screens

–     Discard trolley in the usual manner.

     

NOTE:

  1. If after introducing about 60ml of fluid into the bladder, it does not siphon back, discontinue the washout. Report to the physician immediately.
  2. If urine is not draining ensure that there is no obstruction to the tubing by milking it.

iii.  For Bladder Irrigation

Suspend infusion bottle on drip stand

Connect infusion set to the infusion bottle

Expel air

Connect free end of the infusion set to the supra pubic catheter

Regulate the flow of fluid

 

HOW THE NURSE PERFORMS A BLADDER DRAINAGE

  • If catheter is not already in position, the trolley is set for catheterization.
  • Attach catheter to a long piece of rubber tubing with a wide glass connection.
  • Then the rubber tubing is attached to a drainage bottle, which must have a second opening to let air out.
  • Sometimes the rubber tubing is secured to bed with a safety pin.
  • When bottle is to be emptied the catheter is left draining into a receiver.
  • Measure the urine
  • Bottles are cleaned or changed at least once in 24 hours.

EMPTYING OF BOTTLE

When low-pressure suction pump is used the catheter must be clipped off before disconnecting the glass connection.

The whole apparatus must be connected up again before the clip is removed.  If these precautions are not taken then the suction is destroyed.

Note:

Where a bladder syringe is not available a large funnel and rubber tubing may be used for bladder washout.

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