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TIME

2min

SPECIFIC
OBJECTIVE

CONTENT

TEACHIN
LEARNIN
ACTIVITY
INTRODUCTIO
N
In certain conditions
and after some
surgical procedures
like TURP, the
bladder has lost its
ability to urinate and
excrete out urine
naturally. Therefore
manually the contents
of the bladder like
debris, clots, mucous
as to be removed to
prevent from
infection.
Announcement of the
topic: Today we are
going to discuss

EVALUATION

bladder irrigation.

After the end of


the class the
student will be
able:

3min

DEFINITION
To define
bladder
irrigation

Bladder irrigation can be defined as a process


of flushing out or washing out the urinary
bladder.
OR
Bladder irrigation is a techniques used to flush
blood clots or debris from the bladder by
pushing water solution into the bladder and
immediately draining.

Student teacher
defines bladder
irrigation

What is the
definition of
bladder
irrigation?

5min

To describe the

PURPOSE

Student teacher

What are the

purpose of
bladder
irrigation

5min

To explain the
methods

To cleanse the bladder from decomposed


urine, bacteria, excess mucous, pus and
blood clots.
To relieve congestion and pain in the
case of inflammation.
To promote healing.
To prevent clot formation in case of
bladder surgeries.
To flush out clots & debris out f bladder.
To instill medication to bladder lining.
To restore patency of the catheter.
To prevent or treat infection.
To arrest bleeding.

METHODS
1. OPEN METHOD
Open irrigation means that the closed
drainage system must be opened to the
environment in order to do the bladder
irrigation.
Every time the catheter is disconnected
from the drainage tubing to do the
procedure, there is a great risk of

describes the purpose


of bladder irrigation.

purpose?

Student teacher
explains the methods

What are the


methods?

introducing bacterial contamination into the


urinary bladder. There are also increased
chances of introducing air.

2. CLOSE METHOD
To avoid the hazard of bacterial
contamination present in the open system of
bladder irrigation, the closed system of
bladder irrigation is practiced at present.
Closed system of irrigation is the
continuous system of irrigation or an
intermittent irrigation.
8min

To elaborate the
general
instructions

GENERAL INSTRUCTIONS
The bladder irrigation not to be done
without a specific order. As far as
possible the bladder irrigation are to be
avoided for the fear of introducing
infection and trauma to the urinary
system.
Patients with indwelling catheters
should be kept separate because there is

Student teacher
elaborates the general
instructions

What are the


general
instructions?

5min

To enlist the
required articles

a great risk of microbial transmission


between catheterized patients.
Vigorous irrigation or introducing fluids
with great force will destroy the mucus
lining of the bladder.
Practice strict aseptic techniques. All the
articles that are used for the irrigation
must be sterile and great care must be
taken to prevent introduction of
infection into the bladder.
Wash hands before and after the
procedure.
Maintain an accurate record of the
amount of fluid used for irrigation and
the total amount of urinary drainage.
Irrigation is carried out until the return
flow is clear. The color of the drainage
should be checked and recorded.

ARTICLES
1)
2)
3)
4)

Disposable gloves
Mackintosh
Three way retention catheter
Sterile drainage tubing and bag in place

Student teacher
enlists the required
articles

What are the


articles that are
required?

5) Sterile antiseptic swab


6) Sterile receptacle
7) Sterile irrigation solution warmed or at
room temperature.
a) Normal saline
b) Distilled water
c) Solution as prescribed by physician
8) Infusion tubing
9) IV Stand
10) Kidney tray
11) Paper bag
10min

To explain the
procedure

PROCEDURE
1) Check the physicians order for amount
and strength of irrigating fluid and
reason for irrigation.
2) Preparatory phase :
a) Explain the procedure and purpose to the
client to reduce anxiety.
b) Provide privacy and drape the client.
c) Empty, measure and record the amount
and appearance of urine present in the
urinary bag.
3) Prepare the equipments:

Student teacher
explains the
procedure

What is the
procedure for
bladder
irrigation?

a) Wash hands to reduce transmission of


microorganism.
b) Connect the irrigation infusion tubing to
the irrigating solution and flush the
tubing with solution to remove air.
c) Connect the irrigation tubing to the input
port of the 3-way catheter. Connect the
drainage bag and tubing to the urinary
drainage port if not already in place.
4) Irrigate bladder
a) Intermittent irrigation
Instill the prescribed amount of irrigant.
If specific amount is not ordered, fill up
to 150ml of irrigant.
Clamp the irrigant tubing to prevent
further filling of irrigant.
If physician has ordered the irrigant to
remain in the bladder for a measured
length of time, clamp the drainage tube
and wait for the prescribed length of
time.
Open the drainage tube (the clamp) and
monitor the drainage bag.
b) Continuous bladder irrigation

Adjust the clamp on the irrigation tube


to allow the prescribed rate of irrigation
to flow into the catheter and bladder.
Monitor the color, clarity, debris and
volume as it flows back into the
drainage bag.
5) Tape the catheter securely on the thigh
to prevent catheter from dislodging.
6) Assess the patients condition and
tolerance of procedure.
7) Discard all used disposable articles,
clean and replace reusable articles.
8) Wash hands to prevent cross infection.
9) Record the procedure.
8min

To explain the
NURSING CARE OF A PATIENT
nursing care and
responsibilities Maintaining the patency of the catheter:
a) Frequent checking of the urinary
drainage.
b) Secure the catheter safely to prevent

Student teacher
explains the nursing
care and
responsibilities

How you can


provide nursing
care?

accidental dislodgement.
c) See that the patient is not lying over the
catheter or tubing to obstruct the urinary
flow.
d) The catheter should never be left even
for the short period because it may lead
to retention.
Prevention of infection
a) Practice strict aseptic techniques.
Everything that touches the urinary tract
should be sterile namely the fluids,
catheter, tubings and other equipments.
b) Practice thorough hand washing before
and after the procedure.
c) Cleaning the catheter that is lying
outside the urethra reduces the chances
of urinary tract infection.
d) Increase the fluid intake.
e) Every patient and his relatives should be
taught about the catheter care.
Maintain the comfort and safety of patient
a) Teach the client how to move in bed
with catheters in place.

b) Instruct the patient to take plenty of


fluids.
c) Use restraints for those patients who are
irrational and are continuously pulling
out the catheter.
d) Proper fixation of the catheter may be
added to the comfort of the patient.
Restoring the normal bladder functions
When the bladder is continuously drained with
an indwelling catheter, the bladder becomes
increasing flaccid, it loses its tone. It gives rise
to retention of urine on removal of catheter.
One way to avoid this is establishing a bladder
training program. The catheter is clamped for
increasing lengths of time and then released at
specific specified intervals to allow the
drainage of urine. By this way the bladder is
alternatively stretched and allowed to be empty
thus restoring its normal function.

SUMMARY

Bladder irrigation is
nothing but the flush
out procedure. The
definition, purpose,
methods and general
instructions of
bladder irrigation are
elaborated. Also, the
required articles along
with the procedure
and nursing care and
responsibilities were
discussed.

CONCLUSION
In certain conditions
the bladder has lost its
ability to urinate and
excrete out urine

naturally. Therefore
manually the contents
of the bladder like
debris, clots, mucous
as to be removed to
prevent from
infection.

BIBLIOGRAPH
Y
Sister Nancy;
Nursing
Practice
Textbook;
Edition 8th ,
Page Number
194-206
Anamma
Jacob.Clinical
Nursing
Procedure: The
Are Of Nursing

Practice, 1st
Edition,
Elsevier
Publications,
Page Number
205-206