IRIGASI KATETER, BLADDER TRAINNING, PELEPASAN KATETER

Summary

The video covers three important nursing skills: catheter irrigation, bladder training, and catheter removal. It explains that catheter irrigation is used for post-surgery patients or those with bladder bleeding. Bladder training helps patients regain the ability to sense the urge to urinate after catheter removal. The procedure involves clamping the catheter at timed intervals. Lastly, catheter removal is done once the patient can sense the need to urinate. The video walks through detailed steps for each procedure, emphasizing hygiene, patient comfort, and careful observation during each stage.

Takeaways

• 😀 The training covers three key skills: catheter irrigation, bladder training, and catheter removal.
• 💧 Catheter irrigation is used for post-surgery patients or those experiencing bladder bleeding.
• 🔄 Bladder training is designed to help patients regain the sensation of urination after catheter removal.
• 🛠️ Catheter removal is performed after the patient demonstrates the ability to feel the urge to urinate.
• 🧴 Sterile procedures, such as handwashing and using gloves, are emphasized before starting the catheter irrigation process.
• 💧 For catheter irrigation, NaCl or aquades is used, and the fluid is administered manually to clear any blockages.
• ⏲️ In bladder training, the catheter tube is clamped for 1-2 hours on the first day, gradually increasing the time to promote normal bladder function.
• 🔄 The patient’s urine flow is monitored after each clamp release to check if the bladder is functioning normally.
• 🧼 The catheter removal process includes cleaning the area with NaCl and ensuring no residue remains in the tube.
• 🍶 After catheter removal, patients are advised to consume 1,000-1,500 ml of fluids daily to promote normal urination.

Q & A

What are the three skills being discussed in the script?

The three skills discussed are catheter irrigation, bladder training, and catheter removal.

What is the purpose of catheter irrigation?

Catheter irrigation is used for post-surgical patients or patients experiencing bladder bleeding to ensure that the catheter remains clear and functional.

When is bladder training recommended for patients?

Bladder training is recommended for patients who have been identified as ready to have their catheter removed and need to regain the sensation of needing to urinate.

How is the catheter irrigation process initiated?

The process begins by preparing the irrigation equipment, ensuring no air is present in the fluid, and connecting the irrigation tube to the catheter before beginning fluid flow.

What should be observed during catheter irrigation?

During irrigation, the urine should be observed for its color, checking for blood, and ensuring that there are no blockages in the catheter.

What is the procedure if there is a blockage in the catheter?

If there is a blockage, manual irrigation is performed using a 50cc syringe filled with sterile fluid to remove the blockage, typically caused by blood clots.

How is bladder training conducted over multiple days?

On the first day, the catheter tube is clamped for 1-2 hours, then released. On the second day, the duration is increased to 2-3 hours, and on the third day, to 3-4 hours. The process continues while observing for the patient's ability to feel the need to urinate.

How is the patient's progress evaluated during bladder training?

Progress is evaluated by asking the patient whether they feel the need to urinate. If they regain this sensation, the catheter can be removed even before the full duration of the training process.

What steps are taken during the catheter removal process?

During catheter removal, the patient's position is adjusted, the fluid inside the balloon holding the catheter is aspirated, the catheter is carefully pulled out, and the area is cleaned to prevent infection.

What aftercare is recommended following catheter removal?

After catheter removal, patients are advised to drink around 1000-1500 ml of water daily (about 6-8 glasses) to help restore normal urination.

Outlines

00:00

🩺 Introduction to Three Key Skills: Catheter Irrigation, Bladder Training, and Catheter Removal

This paragraph introduces three essential medical skills: catheter irrigation, bladder training, and catheter removal. Catheter irrigation is performed for post-surgery patients or those with bladder bleeding. Bladder training is used to help patients regain the ability to feel the urge to urinate. Catheter removal is only done once patients experience a natural urge to urinate.

05:08

💧 Step-by-Step Guide to Catheter Irrigation

This paragraph provides a detailed walkthrough of the catheter irrigation procedure. The process begins by preparing the irrigation fluid (either aquades or NaCl), ensuring there is no air in the tube. The irrigation is performed continuously for 24 hours after surgery, and from the second day, the flow is adjusted to 60 drops per minute, gradually decreasing. The urine color is observed to check for blood clots or blockages.

10:11

🩹 Manual Irrigation for Blockages

When blockages are detected, manual irrigation is necessary. This involves disconnecting the catheter tube and using a syringe to flush out the blockage with aquades or NaCl. The process is repeated until the blockage is fully removed. Once urine flows freely, the catheter is reconnected, ensuring the system is functioning properly.

15:14

⏲️ Bladder Training: Regaining Control

Bladder training starts with the clamping of the catheter tube for one to two hours. This procedure is repeated every two to three hours, giving the patient time to regain the sensation of needing to urinate. The process is conducted over three days, with intervals of rest between clampings, and is adjusted based on the patient’s ability to feel the urge to urinate. The goal is to prepare the patient for catheter removal once bladder control is restored.

20:17

🛁 Proper Catheter Removal and Post-Care Instructions

This paragraph covers the catheter removal process. The patient is positioned comfortably, and the catheter is carefully extracted. The area is cleaned, and the patient is monitored for any signs of irritation or infection. The patient is advised to drink 1000-1500 ml of water per day to promote normal urination post-catheter removal. This concludes the entire procedure, including catheter irrigation, bladder training, and catheter removal.

Keywords

💡Catheter Irrigation

Catheter irrigation is a medical procedure to flush out a catheter and bladder to remove blockages or blood clots. In the script, the instructor explains the use of solutions like NaCl or aquades for this process, often applied to post-surgical patients or those experiencing urinary bleeding. It is a key skill demonstrated in the video, where the steps for administering the irrigation are outlined.

💡Bladder Training

Bladder training is a technique used to help patients regain normal bladder control after catheter removal. The video explains how this procedure involves periodically clamping the catheter to allow the patient to feel the natural sensation of needing to urinate. Bladder training is crucial in preparing the patient for independent urination, and the process is detailed with specific timings for clamping and releasing.

💡Catheter Removal

Catheter removal is the process of safely extracting a catheter from a patient's body once it's no longer needed. In the script, this is described as the third skill taught, performed after ensuring the patient has started to regain bladder function. The procedure involves steps like checking for urine flow, using sterile equipment, and observing the patient’s condition post-removal.

💡NaCl Solution

NaCl solution, or saline solution, is used in the video for catheter irrigation. It helps to clear blockages and blood clots within the catheter and bladder. The script emphasizes its role in flushing the system, and the proper handling of NaCl is demonstrated to ensure effective irrigation without introducing air bubbles.

💡Clamping (Catheter)

Clamping refers to the process of closing off the catheter tube temporarily, used during bladder training. In the video, this technique is applied to allow the bladder to fill, helping the patient relearn the sensation of needing to urinate. The script outlines specific intervals, starting with one to two hours on the first day, progressively increasing the clamping duration.

💡Urine Observation

Urine observation is a critical step during catheter irrigation and bladder training. The video stresses the importance of monitoring the color and flow of urine to check for blockages, bleeding, or other abnormalities. For example, the instructor advises checking for signs of blood and ensuring the catheter is not obstructed after irrigation.

💡Sterile Technique

Sterile technique is a medical practice to prevent contamination during procedures such as catheter irrigation, bladder training, and catheter removal. The video highlights the use of gloves, sterilized equipment, and disinfectants (e.g., alcohol swabs) to ensure cleanliness, which is essential for patient safety and to prevent infections.

💡Aquades

Aquades is distilled water used as an alternative to NaCl in catheter irrigation. In the video, it is mentioned alongside NaCl as a possible fluid to flush out the catheter and bladder. The use of aquades ensures that the bladder is irrigated without causing irritation or introducing contaminants.

💡Post-surgical Patients

Post-surgical patients refer to individuals who have recently undergone surgery and may require catheterization to manage urinary output. In the script, these patients are highlighted as common recipients of catheter irrigation, especially if there is a risk of bleeding or urinary obstruction. Their care involves regular monitoring and interventions like irrigation to ensure proper recovery.

💡Urine Bag

A urine bag is a container attached to a catheter to collect urine from the bladder. In the video, it is part of the observation process during catheter irrigation and bladder training. The urine bag allows for visual inspection of urine color, flow, and volume, which are crucial for detecting issues like blockages or bleeding.

Highlights

Introduction to three nursing skills: catheter irrigation, bladder training, and catheter removal.

Catheter irrigation is intended for post-surgery patients and those experiencing bladder bleeding.

Bladder training is used to help patients regain the sensation of urination before catheter removal.

Catheter removal should only be performed after a patient feels the urge to urinate and under specific instructions.

Preparation of the catheter irrigation involves using sterile equipment and solutions such as aquades or NaCl.

During the first 24 hours post-surgery, the irrigation flow should not be restricted, while on the second day, it should be adjusted to 60 drops per minute.

Observing urine color during irrigation helps to assess bleeding and ensure no blockages are present.

In the event of blockages, manual irrigation is performed using a syringe to clear the obstruction.

Bladder training on the first day involves clamping the catheter for one to two hours, then checking if the patient feels the urge to urinate.

The second day of bladder training increases the clamping duration to two to three hours, with regular checks to ensure urine flow and comfort.

On the third day, the duration for clamping the catheter is extended to three to four hours, with further monitoring of the patient's urination sensation.

The catheter removal process is carefully performed by deflating the balloon that holds the catheter in place, ensuring no discomfort for the patient.

Post-catheter removal, the area is cleaned, and the patient is advised to drink 1,000-1,500 ml of fluids to restore normal urination.

Bladder training and catheter removal both aim to restore normal urination sensations for patients.

The procedure emphasizes patient comfort, careful monitoring, and gradual restoration of normal bladder function.

Transcripts

halo salamualaikum warahmatullahi

wabarakatuh Hari ini kita akan belajar 3

keterampilan ya keterampilan yang

pertama terkait dengan irigasi kateter

keterampilan yang kedua terkait dengan

bladder training ketrampilan yang

terpikir terkait dengan pelepasan

kateter baik untuk irigasi kateter itu

ditujukan pada pasien pasien pasca

operasi pembedahan untuk maupun

pasien-pasien yang mengalami perdarahan

pada kandung kemih Kemudian untuk

keterampilan bladder training kita

gunakan untuk pasien-pasien yang sudah

diindikasikan harus dilepas kateter Nya

sehingga pasien tersebut harus bisa

kembali merasakan sensasi ingin berkemih

untuk keterampilan yang ketiga pelepasan

kateter kita lakukan setelah ada

instruksi dan pasien mengalami sensasi

ingin berkemih sehingga pasien

tidak dilepas kateter nya smile hirohman

nirohim

hai hai

yo yo

hai hai

Hai KitKat cuci tangan kita kenakan hand

skun

hai hai

nge-rap naik wasiat Bapak posisinya

sudah nyaman ya seperti ini saya akan

mulai melakukan irigasi pada kateter

bapak

sesuai dengan fitrah

hai hai

hai hai

Hai Permisi saya pasang Perlak ya

diangkat Pak pantatnya Maaf permisi

Hai kemudian kita siapkan di sini ada

Halo selang irigasinya kita pastikan

tidak expired kita buka ya seperti ini

kondisinya ini masih terbuka kuncinya

kemudian kita kunci sudah Setelah itu

kita ambil cairannya ini bisa cairan

aquades ataupun cairan NaCl

Ayo kita pasangkan

hai hai

Hai ujian ini kita Letakkan bengkoknya

kita isi dulu cairannya

Hai dah kemudian kita Gantungkan di

[Musik]

Hai daftar

Ayo kita alirkan agar tidak ada udara

yang masih di dalam cairannya sedang

hai hai

Hai baik eh kemudian setelah itu kita

hubungkan selang irigasinya dengan trewe

kateter kita masukkan

Ayo kita Kencangkan

Hai pastikan sudah terikat kencang

kemudian setelah itu kita alirkan

Oh ya Allah untuk hari pertama pada

pasien post tutup itu teh kita alirkan

maksimal ya ya kita tidak kunci sama

sekali ini untuk 24jam pertama kemudian

selanjutnya pada hari kedua kita atur

tetesannya menjadi 60 tetes per menit

kemudian Pada hari ketiga tetesannya

kita kurangi lagi menjadi 40 tetes

permenit Oke Setelah itu kita pastikan

bahwa Eh urinnya keluar di sini ya di

kantong urine nya bagaimana warnanya

kita observasi apakah masih banyak

darahnya warnanya kemerahan kita

observasi Selain Kita observasi warna

urine di dalam kantong urine baiknya

kita juga pastikan bahwa tidak ada

sumbatan jadi di sini kita plastik

bahwa urinnya mengalir nah kemudian

kalau ada sumbatan kita lakukan irigasi

manual Arabnya Kita lanjutkan ini sudah

ada Perlak nya kita tinggal tambahkan

under part ya di sini kita pasangkan

pada pasiennya

hai hai

Hai permisi ya Pak saya pasang dulu agar

tidak basah kasurnya posisi seperti ini

kemudian kita pasangkan penguncinya kita

dekatkan Setelah itu kita siapkan awet

untuk melakukan irigasi manual kita buka

kita butuh speed ukuran 50cc sebaiknya

seperti ini ujungnya yang seperti ini ya

biar bisa masuk kemudian setelah itu

kita tuangkan ini bisa aquades ataupun

NaCl kita tuang kedalam bengkok

Hai atau kedalam Kom mixer

Hai kemudian kita ambil 50cc

hai hai

hai hai

Hai jejak sudah 50cc kita taruh di bak

dulu Ta bawah kemudian karena ada

sumbatan maka kita harus lepas di bagian

penyambung antara selang kateter dengan

kateter nya

Hai di sini

Oh ya

Hai kemudian kita semprotkan aquades

ataupun NaCl ini kedalam kandung

kemihnya pasien kita semprotkan

Hai kemudian kita ambil lagi 1

Oh ya kita Scott nah

Hai ini tujuannya untuk mengambil

stolsel atau sumbatan yang ada di dalam

kateter nya pasien

Hai ambil

ya udah

Hai kemudian buang ke bengkok

the stool soalnya cukup banyak kemudian

karena masih merah maka kita ambil lagi

1

hai hai

Hai hey kita bersihkan dulu ini masih

banyak merah-merahnya tak buang

Hai hehe Kita taruh sini ya takutnya

orangnya pasien mengalir Nah kita isi

lagi dengan NaCL kita ambil lagi 50cc

hai hai

Ayo kita masukkan lagi terdorong cukup

kuat

Hai kemudian kita cari lagi untuk

mengambil sumbatan nya nya

Hai spek ini masih ada gak merah tetapi

Sumba tanya sudah tidak ada

Hai cukup

yo yah

Ayo kita buang karena sudah tidak ada

sumbatan nya bisa kita sambungkan lagi

yang kuat

Hai yang kita pastikan bahwa urinnya

mengalir ya tidak ada sumbatan di sini

kalau sudah tidak ada sumbatan oleh kita

nafikan lagi untuk proses irigasi sudah

selesai karena sudah lancar tidak ada

sumbatan lagi maka kita bisa bereskan

Baik bapak untuk proses irigasinya sudah

selesai saya rapikan kembali ya Saya

minta dibantu untuk diangkat pantatnya

hai hai

Hai saya ambil Perlak nya saya tutup

kembali

Hai terapi kan lagi pasiennya

Alhamdulillah sudah selesai saya permisi

dulu ya pak soalnya alaikum

warahmatullahi wabarakatuh

Hai nilai rohmani Rohim

hai hai

hai hai

hai hai

hai hai

hai hai

hai eh baik kita mulai ya Pak sesuai

janji kemarin kita akan melaksanakan

latihan otot perkemihan agar Bapak bisa

kembali berkemih dengan normal atau

seperti biasa ya nanti prosedurnya Saya

akan melakukan penguncian di depan

selang kateter bapak untuk hari pertama

ini saya akan melakukan penguncian

sekitar satu sampai dengan dua jam saya

mulai ya Pak saya lakukan Rohim

yo yo

hai hai

Hai nah ini sudah saya kunci Pak nanti

kalau sebelum dua jam Bapak sudah

merasakan nyeri atau sakit di bagian

kandung kemihnya atau dibagian perut

bawahnya kemudian sudah ada perasaan

pengen pipis nanti bapak bisa memanggil

kami begitu ya baik setelah 2 jam kita

cek kita buka

Hai clan-nya atau kuncinya

hai hai

Hai Setelah itu kita lihat

Hai apakah urinnya mengalir atau tidak

Gitu ya sudah kita istirahatkan 15 menit

seperti ini setelah 15menit kita lakukan

pengeboman lagi atau pengujian lagi

tropis Iya Pak saya kunci lagi

I like ini kita lakukan selama 24jam

pertama jadi selama 24 jam pertama

dilakukan penguncian diselang kateter

nya itu sekitar satu sampai dengan dua

jam Setelah 1 sampai dengan 2 jam kita

buka kuncinya dibiarkan urinnya mengalir

kemudian setelah 15menit kita kunci lagi

atau kita klaim lagi kita buang urin

yang ada di dalam penampungan setelah

itu setelah 2 jam kita buka lagi kita

cek lagi apakah ada urine yang keluar

atau tidak Ini untuk hari Bang yang

pertama Kemudian untuk hari yang kedua

nanti durasinya kita tingkatkan menjadi

dua sampai dengan tiga jam waktu

pengakuan Emangnya atau penguncian

selang kateter nya Setelah tiga jam

kemudian kita beri jeda 15 menit agar

pasiennya bisa berkemih begitu ya kita

kasih jeda setelah 15menit kita ulang

lagi kita klem atau kita kunci selama

dua sampai dengan tiga jam pada hari

kedua ini sama waktunya 24jam kita

lakukan pengereman secara berkala setiap

tiga jam sekali kita cek kemudian kita

beri jeda 15 menit untuk mengalir

kemudian setelah 24jam Hadi hari kedua

kita lanjutkan Pada hari ketiga Pada

hari ketiga durasinya kita naikkan

menjadi tiga sampai dengan empat jam

Setelah tiga sampai dengan empat jam

kita buka kembali klaimnya kita alirkan

urinnya ke dalam penampungan urin

setelah 15menit kemudian kita klaim lagi

gitu nah kita sambil evaluasi kepada

pasien di masing-masing tahapan kita

tanyakan ke pasien Apakah sudah

merasakan sensasi ingin berkemih atau

sudah ada perasaan pingin pipis kalau

sudah ada

Aan ingin pipis atau sensasi ingin

berkemih maka itu sudah bisa dilakukan

pelepasan walaupun tadi belum sampai 3

hari sudah pastinya sudah merasakan

pengen pipis sudah bisa mengontrol

tipisnya maka bisa dilakukan pelepasan

kateter ya demikianlah prosedur brader

training yang sudah saya sampaikan

alhamdulillahirobbilalamin sudah selesai

untuk praktikum prosedur play-doh

training smile hirohman nirohim

hai hai

hai hai

Hai pakai sarung tangan

Hai nah kemudian kita siapkan pasiennya

diposisikan yang nyaman baik kosnya

sudah nyaman Pak kemudian diminta untuk

menekuk lututnya silahkan lututnya

ditekuk Setelah itu kita pasang Perlak

dan bengkok Permisi Pak

Hai diangkat ya kita pasang Perlak ya

udah

Hai setelah itu bengkok ah kemudian kita

siapkan alatnya ada spuit ini untuk

mengambil air yang digunakan untuk

mengkunci

hai hai

Ayo kita ambil cukup kita putar saja

Kemudian airnya akan keluar sendiri

Hai the Kita buang

ia tampil lagi sampai semuanya yang ada

di dalam

Hai keluar dah Ini sudah berhenti Kita

pastikan bahwa tidak ada yang tersisa

kita aspirasi

Hai dah tidak ada lagi kita buang

Hai sudah baik Setelah itu kita buka

Playstore nya gunakan alkohol Sweep agar

tidak nyeri

hai hai

Hai ini siapa anget

hai hai

hai hai

hai hai

hai hai

ya udah

Hai sudah sudah tidak menempel lagi

kemudian kita bisa ambil sang kateter

nya boleh menggunakan tangan langsung

ataupun dengan bantuan pinset

Hai Tamil

Hai isi Tarik nafas ya Pak kalau sakit

tahan sebentar

hai hai

Hai nah kemudian kita letakkan di

bengkok

Ya udah selanjutnya selangkah teater dan

juga kateter nya bisa kita eh buang ke

dalam plastik tabungam setelah dibuang

kemudian kita bersihkan area kemaluan

pasien kita ambil Casa

Ayo kita masukkan ke dalam com

Hai dikata cukup kemudian setelah itu

kita tuang NaCl

hai hai

Hai selanjutnya kita apras

hai hai

hai hai

hai hai

hai hai

hai hai

Hi Ho

hai hai

yo yo

ke daftar Kementerian kita pegang di

kemaluannya pasien kita bersihkan

ujungnya

Hai bersihkan sampai bersih

Hai Haryono atasnya

hai hai

hai hai

hai hai

hai hai

hai hai

hai hai

Hai Keh setelah bersih kemudian kita

amati Apakah ada kemerahan kemudian rasa

gatal di area kemaluan kalau ada

kemerahan perlu kita berikan salep gitu

baik sudah selesai Bapak untuk pelepasan

kateter nya Permisi saya ambil ternaknya

saya bereskan dulu perlengkapannya

hai hai

hai hai

hai hai

ya alhamdulillah sudah selesai untuk

pelepasan kateter Bapak selanjutnya

bapak bisa mengkonsumsi minuman paling

tidak sekitar 1000-1500 perhari atau 6

sampai dengan 8 gelas agar nanti

pipisnya kembali normal demikian bapak

untuk Proses pelepasan hari ini

wassalamu'alaikum warahmatullahi

wabarakatuh

Hai demikian rangkaian dari keterampilan

irigasi kateter bladder training dan

juga pelepasan kateter semoga bermanfaat

wassalamualaikum warahmatullahi

wabarakatuh

hai hai