BLADDER_IRRIGATION[1] Mr. Tarique. 23.pptx

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1. BLADDER IRRIGATION MD TARIQUE ANWAR B.SC[NSG] 4TH YEAR SESSION:-2020-24

2. BLADDER IRRIGATION

3. 1. INTRODUCTION. 2.DEFINITION. 3.PURPOSES. 4.SOLUTION USES. 5.GENERAL INSTRUCTIONS. 6.TYPES. 7.PRELIMINARY ASSESSMENT CHECK. 8.PREPARATION. 9.ARTICLES/EQUIPMENTS. 10.PROCEDURE. .

4. 14 . AFTER CARE. 15.DOCUMENTATION. 16.CATHETER CARE. 17.COMPLICATION. THE END.

5. BLADDER IRRIGATION:- Bladder:- The bladder is a hollow, balloon shaped organ in the lower part of the abdomen that stores urine. Irrigation :- It means flushes your bladder with a sterile liquid.

6. DEFINITION:- Bladder irrigation or wash is defined as washing of the urinary bladder directly by a stream of solution into the bladder through the urinary meatus by means of a catheter tubing and funnel. OR Bladder irrigation means to flush out the urinary bladder with a liquid.

7. PURPOSE S : - To cleanse the bladder from decomposed urine bacteria, excess mucus & 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 & pain in case of inflammatory condition of cystitis. To arrest bleeding & prevent clotting of blood.

8. SOLUTION USES SOLUTION USES:- ; 1. Normal saline.[0.9%] Boric acid [2%] Sterile water 4. Acetic acid[1:4000]pseudomonas infection 5.Sodium nitrate [1:8000]clot formation 6.Acriflavin [1:10;000] 7.Silver nitrate [1:5000] 8.potassium permanganate.

9. GENERAL INSTRUCTION:- The temperature of the solution needed for cleaning purpose body temperature is enough. The temperature of the solution needed for therapeutic purposes ranging from 100 to 110(Degree fahrenheit). Wash hand before and after the procedure. practice strict aseptic technique.All the articles that are used for the irrigation must be sterile.

10. 5.Should not be done without written order. 6.If the fluid flows easily in to the bladder but fails to return ;there is a clot over the eye of the catheter.

11. SIGNS OF A BLOCKED CATHETER:- No urine flow from the catheter. By passing around the catheter. The patient complaining of suprapubic pain. If unrelieved vaso-vagal symptoms may be develop.eg:-Tachycardia; Hypotension etc.

12. TYPES:- There are following types:- 1.Manual bladder irrigation:- Manual bladder irrigation(BGI) is used for clearing clot retention. Catheter blockage is a very common complication in long term catheter users. up to 50% of long term catheter are changed prematurely due to catheter blockage.

13. 2.Continuous bladder irrigation:- To prevent blood clot formation ;allow free flow of urine & maintain patency by continuously irrigation the bladder with normal saline.

14. PRELIMINARY ASSESSMENT CHECK:- 1. Dr. orders for specific precaution & instructions. 2.Assess the general condition of the patient. 3.Self care ability of the patient. 4.Articles available in the unit. 5.Mental status to follow instructions.

15. PREPARATION OF THE PATIENT ENVIRONMENT:- Explain the sequence of the procedure. Arrange the articles at the bedside. Provide privacy. Place the patient in comfortable position. Place the mackintosh under the buttock.

16. ARTICLES:- A sterile catheterization pack. Catheter tip 50ml syringe =1 Chlorhexidine swabs 70% alcohol. Blue under sheet. Unsteile jug. 500ml bottle of normal saline. PPE ie sterile gloves, goggles & Apron. Dressing pack=1 3 way catheter.

17. 10. Iv pole. 11. Bucket. 12. Solution thermometer kept in antiseptic solution in a bottle if available. 13.A small mug or pint measures to pour solution. 14.Bed pan. 15.Artery foreceps, thumb forceps ,gauze piece ,water in a basin,betadine, kidney tray.

18. PROCEDURE: - Explain procedure to the patient &ensure patient privacy. Proper hand washing. Position the patient for easy access to the catheter whilst maintaining patient comfort. Maintain asepsis (this is done as an aseptic procedure to prevent a UTI as the closed urinary drainage system is being broken).

19. 5.Place blue sheet under the catheter and drainage bag connection. 6.Prepare sterile setup with 500N/S in kidney dish. 7.Place unsterile jug on bottom of trolley. 8.Wear gloves & empty the bladder keeping outlet of catheter unvontaminated. 9.After urine withdrawal;attach glass; connection ;tubing & funnel to the catheter.

20. 10.Place bucket or kidney tray conveniently near the meatus. 11.Hold the funnel lowered with one hand with other hand pours 75 to 100ml of solution along sides of the funnel. 12.Raise the tube & keep the funnel 30cm above bed level. 13.Never allow the funnel to be empty, lowe the funnel & slowly invert in over the bucket.

21. 14.Repeat pocedure until the return flow is clear. 15. At the end of the procedure ,clamp tubing disconnects glass connection, tubing & funnel, gently remove catheter & complete. 16.In case of self retaining catheter ,connect it to the drainage bag.

22. AFTER CARE:- 1. Provide catheter care. 2.Remove the mackintosh & position the patient comfortably. 3.Cover the patient with bedsheets. 4.Replace the articles after cleaning. 5.Wash hand throughly. 6.Record the procedure & observation in the nurse;s record sheet.

23. DOCUMENTATION:- Date and time of procedure. indication for the manual irrigation including to the patients clinical symptoms. Result of irrigation ie volume of return ,described output /clots/ debris/and also color of urine. on the fluid balance chart record volume infused volume returned and the difference being urine volume.

24. CATHETER CARE:- Always wash hands before and after handling a catheter follow all of the instructions the Dr. has given :- Make sure that urine is flowing out of the catheter into the urine collection bag. keep the urine collection bag below the level of the bladder. 3) Make sure that the urine collection bag does not drag & pull on the catheter.

25. 4) Check for inflammation or signs of infection include in the area of around the catheter.signs of infection ie:- pus ,swollen Red ,or tender skin. 5) Clean the area around the catheter twice a day with soap & water. Dry with a clean towl afterward. 6)Don;t apply powder or lotion to the skin around the catheter. 7)Don;t tug or pull on the catheter. 8)At night it may be helpful to hang the urine collection bag on the side of the bed.

26. COMPLICATION:- Bladder spasm. uretheral irritation. tissue trauma. infection. THE END......