BLADDER IRRIGATION

DEFINITION: - Bladder irrigation is a procedure in which sterile fluid is used to prevent clot retention by
continuously irrigating the bladder via a three-way catheter. 

(Gilbert and Gobbi, 1989).

Flushing out/washing out the urinary bladder with specified solution.

TYPES OF BLADDER IRRIGATION:-

1. Continuous irrigation
2. Intermittent irrigation
For continuous irrigation:-
1. Open the flow clamp on the urinary drainage tubing. This allows the irrigating solution to flow out of
the bladder continuously.
2. Open the regulating clamp on the irrigating tubing and adjust the flow rate as prescribed by the
primary care provider or 40-60 drops per minute if not specified.
3. Assess the drainage for amount, color and clarity. The amount of drainage should equal the amount of
irrigant entering the bladder plus expected urine output.
      For intermittent irrigation:-
1. Determine whether the solution is to remain in the bladder for a specified time.
2. If the solution is to remain in the bladder, apply flow clamp to the urinary drainage tubing. Closing
the flow clamp allows the solution to be retained in the bladder and in contact with bladder walls.
3. If the solution is being instilled to irrigate the catheter, open the flow clamp, on the urinary drainage
tubing. Irrigating solution will flow through the urinary drainage port and tubing, removing mucous
shreds or clots.
4. Open the flow clamp on the irrigating tubing, allowing the specified amount of solution to infuse.
Clamp the tubing.
5. After specified period the solution is to retained, open the drainage tubing flow clamp and allow the
bladder to empty.
6. Assess the drainage for amount, color and clarity. The amount of drainage should equal the amount of
irrigant entering plus expected urine output.
7. Assess the client and the urinary output.- assess the client’s comfort.
8. Empty the drainage bag and measure the contents. Subtract the amount of irrigant instilled from the
total volume of drainage to obtain the volume of urine out put.9) Document the procedure and results
in the clients records. Use forms or checklists supplemented by narrative notes when appropriate.
9. Note any abnormal constituents such as blood clots, pus or mucous shreds.

PURPOSES:-
1. To flush clots and debris out of the catheter and bladder.
2. To instil medication to bladder lining.
3. To restore patency of the catheter.

INDICATION:-

1. Urinary distension.
2. Hydronephrosis.
3. Chronic obstruction.
 4. Blood clot.
5. Post TURP (Tran’s urethral resection of Prostate).
6. Post ESWL (Extracorporeal shockwave Lithotripsy).

ARTICLES:-

1. Disposable gloves.
2. Disposable, water resistant, sterile towel/ mackintosh.
3. Three way retention catheter in situ.
4. Sterile drainage tubing and bag in place.
5. Sterile antiseptics swab.
6. Sterile receptacle.
7. Sterile irrigating solution warmed or at room temperature.
a) Normal saline.
b) Distilled water.
c) Solution as prescribed by physician.

8. Infusion tubing.
9. I/V pole.
10. Kidney basin.

PROCEDURE:-

S.NO. NURSING ACTION RATIONALE

1. Check physician’s order and nursing care
plan for type, amount and strength of
irrigating fluid and reason for irrigation.
2. Prepare the patient
a) Explain the procedure and its Clear explanation reduces anxiety.
purpose to the patient.
b) Provide for privacy and drape the
patient.
c) Empty, measure and record the Emptying the bag allows for more accurate
amount and appearance of urine measurement of urinary output after irrigation.
present in the urine bag. Assessment of character of urine helps in obtaining a
baseline assessment data for letter comparison.
3. Prepare the equipment
a) Wash hand. Reduces transmission of microorganism.

b) Connect the irrigation infusion Flushing the tubing removes air and prevents it from
tubing to the irrigating solution being instilled into the bladder.
and flush the tubing with
solution.
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
 Instil the prescribed amount of The bladder normally feels full when it contains
irrigant. If specific amount is 300ml of urine.
not ordered, fill up to 150ml of
irrigant.
 Clamp the irrigant tubing. Prevents further instillation of irrigant.
 If the physician has ordered the Some irrigation solution contain medication and are
irrigant to remain in the meant to remain in contact with the bladder wall the
bladder, for a measured length for a prescribed length of time.
of time, clamp the drainage
tube and wait for the prescribed
length of time.
Assesses the drainage for volume, color, clarity and
 Open the drainage tube (the
the presence of any clots or debris.
clamp) and monitor the
drainage as it flows into the
drainage bag.
b) Continuous bladder irrigation. Regulates the amount of irrigant flowing in and out
 Adjust the clamp on the of the bladder to prevent distension or damage to any
irrigation tubing to allow the surgical site.
prescribed rate of irrigant to
flow into the catheter and
bladder. Assesses for bleeding, clotting, and blockage of
 Monitor color, clarity, debris urine drainage or other complications.
and volume as it flows back
into the drainage bag.
5. Tape the catheter securely to the thigh. Prevents the catheter from dislodging.
6. Assess the patient’s condition and
tolerance of procedure.
7. Discard all used disposable article, clean
and replace reusable articles.
8. Wash hands. Prevents spread of micro-organisms.
9. Record procedure in nurse’s record.

COMPLICATIONS
 Bladder rupture
 Bladder injury
CONCLUSION
 Bladder irrigation is a flushing or washing out with a specified solution, usually to wash out the
bladder and sometimes to apply a medication to the bladder lining.
 BIBLIOGRAPHY

1. POTTER & PERRY’S Text book of ‘‘FUNDAMENTAL OF NURSING”

South Asian Edition. PUBLISHED BY: - Elsevier publication. PAGE NO:-751-752.

2. WILKINSON M. JUDITH “FUNDAMENTAL OF NURSING’’

EDITION:- 2ND Edition . PUBLISHED BY:- F.A. Davis. PAGE NO:- 296-297.

3. LIPPINCOTT’S ‘‘NURSING PROCEDURES”

EDITION:- 5TH Edition . PUBLISHED BY: - Jaypee brothers. PAGE NO:- 60-63.

4. JACOB ANNAMMA ‘‘CLINICAL NURSING PROCEDURES’’

EDITION: - 1ST Edition. PUBLISHED BY:- Wolter kluwer. PAGE NO.-133.

INTERNET

1. www.wikipedia.com.