Bladder Irrigation (CBI) Part #2 exam| 11 questions fully solved

Purpose of Continuous Bladder Irrigation: CBI -Cleanse the lumen of the catheter for patency -Instillation of solution to remove mucus, clots -Application of medication to the bladder wall * all require an MD order -Prevent infection and catheter obstruction by irrigating bladder with a continuous solution Closed Method -Performed without disrupting the closed drainage system by using a triple lumen catheter -One for balloon, one for removal of urine (drainage bag), one for instillation of sterile irrigating fluid and /or medication -Less chance for introduction of microorganisms Equipment -Irrigating solution, labeled: bladder irrigant, date, time, initials -Triple lumen catheter -CBI or Cysto Tubing -IV pole adjust to keep clear -40-60 gtts/min(if not specified) -Sterile large drainage bag -Clean disposable gloves, goggles DO NOT LET IRRIGATION BAG EMPTY Drip Order/Guidelines Amber (yellow) 20-40 gtts/min Tea (orange-brown) same Light rose' (light pink) same Dark rose' (darker pink) 60-80 gtts/min Burgundy 100-120 gtts/min Bright red call MD Purpose of Manual (Intermittent) Irrigation -Maintain the patency of the catheter -Prevent clot formation -Clear lumen of debris -Prevent urinary retention -Associated risk of infection (UTI) Intermittent Closed/Open Procedure Use with a double lumen or two- way Foley Equipment: •Gloves-sterile and non-sterile •Sterile irrigation set containing bulb syringe or Toomey (catheter tip syringe) or luerlock for closed, container, and sterile solution ordered-usually normal saline •Catheter clamp (open) •Bath Blanket •Alcohol wipes Manual Irrigation Using a Port Closed Method-Procedure -Cleanse the access port with antimicrobial swab -Clamp or fold catheter under the access port -Remove cap and insert needle into the port -Alternately, attach the syringe to the port use a twisting motion if needleless system is in place -Gently instill solution into the catheter -Remove syringe from the port -Unclamp or unfold tubing and allow irrigant and urine to flow into drainage bag -Secure catheter tubing to patient -Secure drainage bag below the level of the bladder and is not kinked -Dispose of equipment, hand hygiene and assess response Open Procedure -Don Sterile gloves -Using sterile technique, cleanse the junction between the urethral catheter and the drainage tubing -Disconnect the catheter and drainage tubing, letting the tip of the drainage tubing rest over the edge of the drainage receptacle -Cover the tip of the catheter with the cap provided in the tray -Swab end of the catheter with alcohol and insert syringe into catheter -Using a sterile syringe-bulb (asepto) or catheter tip, instill the amount (usually 30-50 ml) and type of solution -Slowly with gentle pressure into the catheter and allow to drain in the receptacle -Allow return by gravity or aspirate Bladder Instillation of Medications If medication is being instilled into the bladder, clamp after instilled for the prescribed amount of time May use Hoffman or Kelly clamp Documentation Subtract the amount of irrigation used from the amount of drainage in the drainage bag for closed or receptacle for open Record on I&O Remove supplies and dispose of properly Document: •Amount of solution instilled •Return of solution- color, amount, character •Reaction of patient