Definition
Performing a bladder irrigation is a therapeutic nursing procedure used to flush the bladder with a sterile solution. It helps maintain catheter patency, remove clots or debris, and sometimes deliver medication directly to the bladder lining.
Purpose
- To flush clots and debris out of the catheter and bladder.
- To instill medication to bladder lining.
- To restore patency of the catheter.
Articles
- Disposable gloves.
- Disposable, water resistant, sterile towel/mackintosh.
- Three-way retention catheter in situ.
- Sterile drainage tubing and bag in place.
- Sterile antiseptic swab.
- Sterile receptacle.
- Sterile irrigating solution warmed or at room temperature:
a. Normal saline.
b. Distilled water.
c. Solution as prescribed by the physician. - Infusion tubing.
- IV pole.
- Kidney basin.
PROCEDURE
| NURSING ACTIONS | RATIONALE | |
| 1. | Before procedure Check the physician’s order and nursing care plan for type, amount, and strength of irrigating fluid, and reason for irrigation. | |
| 2. | Prepare the patient: Explain the procedure and its purpose to the patient. Provide for privacy and drape the patient. Empty, measure, and record the amount and appearance of urine present in the urine bag. | Clear explanation reduces anxiety. Emptying the bag allows for more accurate measurement of urinary output after irrigation. Assessment of character of urine helps in obtaining a baseline assessment data for later comparison. |
| 3. | During procedure Prepare the equipment: Wash hands. Connect the irrigation infusion tubing to the irrigating solution and flush the tubing with solution. 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. | Reduces transmission of microorganisms. Flushing the tubing removes air and prevents it from being instilled d into the bladder. |
| 4. | Irrigate bladder: Intermittent irrigation: Instill the prescribed amount of irrigant. If specific amount is not ordered, fill up to 150 ml of irrigant. Clamp the irrigant tubing. If the 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 as it flows into the drainage bag. Continuous bladder irrigation: Adjust the clamp on the irrigation tubing to allow the prescribed rate of irrigant to flow into the catheter and bladder. Monitor colour, clarity, debris, and volume as it flows back into the drainage bag. | The bladder normally feels full when it contains 300 ml of urine. Prevents further instillation of irrigant. Some irrigation solutions contain medication and are meant to remain in contact with the bladder wall for a prescribed length of time. Assesses the drainage for volume, colour, clarity, and the presence of any clots or debris. Regulates the amount of irrigant flowing in and out of the bladder to prevent distension or damage to any surgical site. Assesses for bleeding, clotting and blockage of urine drainage or other complications. |
| 5. | Tape the catheter securely to the thigh. | Prevents the catheter from dislodging. |
| 6. | After procedure Assess the patient’s condition and tolerance of procedure. | |
| 7. | Discard all used disposable articles, clean, and replace reusable articles. | |
| 8. | Wash hands. | Prevents the spread of microorganisms. |
| 9. | Record procedure in nurse’s record. |
Special Considerations
- Use aseptic technique to prevent infection
- Never force irrigation if resistance is met—risk of trauma
- Monitor for bladder distention, pain, or leakage
- For manual irrigation, use a syringe and instill slowly
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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