Continuous Bladder Irrigation and Care of a Foley Catheter

Summary

This video demonstrates a nurse, Megan, providing post-surgery care to a patient, Mr. Miller, after a transurethral resection of the prostate. Megan explains the use and function of a three-way catheter system for continuous bladder irrigation, addressing common patient concerns like bladder spasms and the need for catheter maintenance. She also discusses discharge instructions, including the proper care and switching between a gravity bag and a leg bag, with emphasis on infection prevention, hygiene, and follow-up care. The demonstration also includes patient education through a return teach-back method to ensure understanding.

Takeaways

• 😀 The patient, Mr. Miller, is recovering from a transurethral resection of the prostate and requires continuous bladder irrigation with a three-way indwelling urinary catheter.
• 😀 The nurse, Megan, explains the setup of the catheter, which includes three channels for fluid infusion, drainage, and balloon inflation.
• 😀 The nurse emphasizes the importance of not tugging on the catheter to avoid complications like bleeding or clot formation.
• 😀 The drip rate of the irrigation solution is adjusted based on the color of the drainage, with faster rates for darker drainage and slower rates for lighter drainage.
• 😀 Continuous bladder irrigation helps prevent clot formation after prostate surgery by flushing the bladder.
• 😀 Mr. Miller expresses concern about going home with the catheter in place, and Megan reassures him about the plan to switch to home care with fewer bags.
• 😀 The nurse provides Mr. Miller with two types of drainage bags: a gravity bag and a leg bag, explaining their proper use and when to switch between them.
• 😀 The gravity bag should always be positioned below the bladder but never touch the floor to prevent infection.
• 😀 The leg bag should only be worn while active and hidden under clothing. It must not be used while sleeping to avoid potential urinary tract infections (UTIs).
• 😀 Proper catheter care at home includes washing hands before and after care, cleaning the catheter site daily with mild soap, and avoiding baths to minimize infection risk.

Q & A

What is the purpose of the three-way indwelling urinary catheter in this patient's care?

The three-way indwelling urinary catheter is used to provide continuous bladder irrigation following a transurethral resection of the prostate. Its purpose is to prevent clot formation and help drain the bladder effectively by continuously irrigating it with a sterile solution.

Why does the patient feel like he has to urinate constantly after his procedure?

The feeling of constant urgency to urinate is often due to bladder spasms, the presence of the catheter, or irritation from the procedure itself. These are common after a transurethral resection of the prostate.

What are the three channels of the catheter, and what are they used for?

The catheter has three channels: the first channel is for the infusion of sterile solution to irrigate the bladder; the second channel is for draining the solution and urine into a gravity bag; the third channel is for inflating the balloon that holds the catheter in place within the bladder.

What is the significance of monitoring the color of the drainage from the catheter?

The color of the drainage helps the nurse adjust the drip rate of the irrigation solution. Darker drainage indicates more bleeding and requires a faster drip rate, while lighter drainage indicates less bleeding and allows for a slower drip rate.

What should the nurse do if the drainage output is less than the infused solution?

If the drainage output is less than the infused solution, the nurse should check for kinks in the tubing or a clot in the bladder that might be blocking the catheter. In such cases, the catheter may need to be manually irrigated to break up the clot.

What precautions should the patient take to avoid urinary tract infections (UTIs) at home?

To avoid UTIs, the patient should wash their hands thoroughly before and after catheter care, avoid letting the catheter or bags touch the floor, and ensure proper catheter hygiene by cleaning the catheter site daily with mild soap and water. The patient should also avoid baths and apply no ointments or creams unless directed by their urologist.

Why is the leg bag only worn when the patient is up and about?

The leg bag should only be worn while the patient is up and about because if the legs are elevated during sleep, urine could back up into the bladder, potentially causing a urinary tract infection. The gravity bag is used when the patient is lying down.

What steps are involved in switching from the gravity bag to the leg bag?

To switch from the gravity bag to the leg bag, the patient must first pinch the catheter to prevent leaks, clean the catheter site with an alcohol swab, and then connect the leg bag. The connection should be done carefully to avoid contamination. Afterward, the patient can hide the leg bag under clothing.

How should the patient empty the leg bag, and when should this be done?

To empty the leg bag, the patient should detach it from the leg, turn the pour spout counterclockwise over a toilet to allow it to drain, and then close it. This should be done when the bag is about halfway full to prevent overfilling.

Why is it important to wash hands before and after catheter care?

Washing hands before and after catheter care is crucial to prevent contamination and reduce the risk of urinary tract infections. Proper hand hygiene minimizes the transfer of bacteria to the catheter and the surrounding area.