IRRIGATING CYSTOCLYSIS Definition of Terms: Cystoclysis is a type of irrigation wherein saline solution is introduced into the bladder. It is also called as continuous bladder irrigation. Purpose of Irrigating Cystoclysis •to drain the bladder when acute urinary retention is present •to relieve bladder spasm •to prevent formation of calcific deposits in and around the indwelling catheter •to free blockage in the urinary catheter or tubing Indications •Urinary Tract Infection •Post-genitourinary surgery •Prostatic hematuria
Contraindications •Hypersensitivity to the solution to be used •Patients with defects in the bladder mucosa or bladder wall Complications of Irrigating Cystoclysis •Infection – Cystoclysis is an invasive procedure that it may cause infection if not performed aseptically. Open system poses greater risk for infection since it involves opening of the close drainage system. •Trauma to the wall of the bladder – too much pressure may traumatize the bladder wall. •Bladder Spasms – if the irrigation solution used is too cold. •Bladder Distention if the tubing has been kinked, not patent, induce secondary hemorrhage, clamp is closed by stretching the coagulated blood vessel in the prostatic capsule Scientific Principles Involved in Irrigating Cystoclysis •Microbiology Observing the aseptic technique is a must to avoid complication. •Psychology Explaining the procedure to the client helps him/her relax, reduce anxiety and cooperate during the procedure. •Anatomy and Physiology We have to know the parts involved in the procedure and its function to give the right health teachings.
And so as not to cause further injury to the organ and other structures involved. •Physics Avoid too much pressure to prevent causing trauma to the wall of the bladder. Types of Irrigating Cystoclysis 1. Closed Bladder Irrigation System -does not require that the system be opened -for frequent intermittent irrigations or continuous irrigation without disrupting the sterile alignment of the catheter and drainage system through use of a three-way catheter 2. Open Irrigation System -The bladder is drained using a 60-mL syringe. opening of the closed drainage system to instill bladder irrigations -is used when bladder irrigations are required less frequently and there are no blood clots or large mucous fragments -poses greater risk for causing infection Guidelines Involved in Irrigating Cystoclysis a. Determine whether the irrigation will be open or close. b. Observe universal precaution. c. Set up sterile irrigating supplies, maintaining sterile technique per agency protocol. d. Use only clearly labeled or prepared solutions for irrigation. e.
Flush tubing prior to irrigation to clear air from the tubing that might cause bladder distention. f. Check for bladder distention – detects whether catheter is malfunctioning or blocking urinary drainage. g. Cleanse site of entry or end of Y-connector with an antiseptic/disinfectant. h. Monitor and maintain correct flow rate as necessary. i. Check urine output every hour. j. Do necessary documentation. Nursing Responsibilities Before: 1. check physician’s order for type of irrigation and irrigation solution to use, date, time room and name of the client 2. explain the procedure to the client . gather the necessary materials 4. do medical handwashing 5. open the IV tubing then do priming 6. assess lower abdomen for bladder distention 7. position the patient -dorsal recumbent or supine During: 1. drape the patient exposing the leg where the catheter is being taped 2. do gloving 3. cleanse the catheter injection port with antiseptic swab 4. regulate the flow rate in its ordered rate 5. measure urine output every hour After: 1. after care 2. do proper documentation – amount of solution used as irrigant, amount returned as drainage, characteristics of output, calculation