Urinary Catheter Irrigation
December 18, 2010 · Leave a Comment
To avoid introducing microorganisms into the bladder, urinary catheter irrigation is only done to remove obstruction such as a blood clot that develops after bladder, kidney, or prostate surgery.
- Use caution if the patient has recently had prostate, bladder, ureteral, or kidney surgery.
- Ordered irrigating solution such as normal saline
- Sterile graduated receptacle or emesis basin
- Sterile bulb syringe or 60 ml catheter tip syringe
- Two alcohol pads
- Sterile gloves
- Linen-saver pad
- Intake-output sheet
- Basin of warm water
Preparation of Equipment
- Check the expiration date on the irrigating solution and warm the solution to room temperature to prevent vesical spasms during instillation.
- Place the container basin of warm water
- Wash your hands and assemble the equipment at the bedside.
- Check the physician’s order for the dressing change and for any pre-procedure analgesics to be administered.
- Verify the patient’s identity using two patient identifiers, such as the patient’s name and identification number.
- Place the patient in dorsal recumbent position
- Place a linen-saver pad under the patient’s buttocks to protect bed linens
- Create a sterile field at the patient’s bedside by opening the sterile equipment tray or commercial kit.
- Clean the lip of the solution bottle by pouring a small amount into a sink or waste receptacle, using sterile technique.
- Pour the prescribed amount of solution into the graduated receptacle or emesis basin.
- Place the tip of the syringe into the solution
- Squeeze the bulb or pull back the plunger and fill the syringe with appropriate amount of solution.
- Open the package of alcohol pads and put on sterile gloves
- Clean the juncture of the catheter and drainage tube with an alcohol pad to remove as many bacterial contaminants as possible.
- Disconnect the catheter and drainage tube by twisting them in opposite directions and carefully pulling them apart without creating tension on the catheter.
- Don’t let go of the catheter-hold it in your non-dominant hand.
- Place the end of the drainage tube on the sterile field.
- Keep the end of the drainage tube sterile by placing sterile gauze over it.
- Twist the bulb syringe or catheter tip syringe into the catheter’s distal end.
- Squeeze the bulb or slowly push the plunger of the syringe to instill the irrigating solution through the catheter.
- Refill the syringe and repeat this step until you’ve instilled the prescribed amount of irrigating solution.
- Remove the syringe and direct the return flow from the catheter into a graduated receptacle or emesis basin.
- Wipe the end of the drainage tube and catheter with the remaining alcohol pad.
- Wait a few seconds until the alcohol evaporates, then reattach the drainage tubing to the catheter.
- Dispose all used supplies properly.
- Catheter irrigation requires strict sterile technique to prevent bacteria from entering the bladder.
- The end of the catheter and drainage tube and tip of the syringe must be kept sterile throughout the procedure.
- The physician may order a continuous irrigation system, which decreases the risk of infection by eliminating the need to disconnect the catheter and drainage tube repeatedly.
- Encourage the patient not on restricted fluid intake to increase intake to 3,000 ml per day to help flush the urinary system and reduce the sediment formation.
- To keep the patient’s urine acidic and help prevent calculus formation, tell him to eat foods containing ascorbic acid, including citrus fruits and juices, cranberry juice, and dark green and deep yellow vegetables.
- Reinforce that the patient remains as still as possible and should report any discomfort during procedure.
- Introduction of bacteria into the urinary tract can produce a urinary tract infection.