› Bladder Irrigation

Bladder Irrigation Demonstrations

There are several ways to perform bladder irrigation and several reasons for it. Your physician orders will specify which is to be administered and how often. Some irrigants may come from the pharmacy as they will contain medication, or you may be using sterile normal saline that is "off the shelf". I have seen one or two urologists prefer sterile water as they feel it breaks up blood clots in the bladder better than saline, but generally you want to keep the osmolity of the bladder normal so saline is the fluid of choice.

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Whatever comes from the pharmacy, make sure it is the right patient, the right medication, the right dosage... well, ok, you should have all the "rights" of medication down pat. If not, review them.

Remember that the bladder is considered sterile, so fluid goes in needs to be as well. There are portions of your supplies that are sterile and others that are merely clean. Non-sterile exam gloves are sufficient.

Single Irrigation Administration

When the video says to maintain the inside of the container, she means the container that holds the syringe, not the outer container.

The syringe sometimes has a cap on the tip, so check before you go further and remove it being careful not to actually touch the syringe itself.  In addition, those catheters can be hard to pull up the fluid one handed, so you may want to get your 30-50 mls. in the syringe before you disconnect the catheter so it is ready to go. 

The ends of the catheter and the drain tubing are considered sterile. You don't want new bacteria introduced by having either of those ends touch the bed or you or the patient. Take precautions to keep sterile. If you mess up grab a few of those alcohol prep pads you always carry in your pocket and clean off well 15-30 seconds. (Singing Happy Birthday to yourself is about 15 seconds if you can't get to your watch.)

While you are performing the irrigation, be aware of how much tension you are putting on the catheter. It would be painful to the patient to have you tugging on it as the inflated balloon in the bladder would put pressure on the urethra. 

Single Irrigation Administration without Disconnecting Tubing

Clamping off the tubing below the port where you are injecting the normal saline keeps the irritant from taking the path of least resistance down instead of up into the bladder. If you are a fumbler, bring a rubber band to wrap around the kink so you can let go of it while you do the urinary irrigation. As you continue with your nursing practice, at some point you will realize you have grown that ever necessary third hand and won't need the extra help.

CBI = Continuous Bladder Irrigation.

While you are injecting the one time urinary irrigation, you will turn off the continuous fluid until you are done. 

Don't forget to wipe the port where you stick the needle in at a 45 degree angle with alcohol. "Happy Birthday to you..."

Continuous Bladder Irrigation Using On-Off Valves 

These large, 60 mls. syringes are called catheter tip syringes for the obvious reason that they fit into the foley catheter without any need for an adapter.

Urinary Nursing Skills

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