(g) Insert the distal end of the I.V. tubing securely into the inflow lumen
of the catheter. (The outflow lumen should already be attached to tubing leading to the
(h) Open the flow clamp on one of the containers of irrigating solution
and set the drip rate as ordered.
(4) Switch to the reserve container when the first container of irrigating
solution is nearly empty.
(a) To prevent air from entering the system, do not allow the primary
container to empty completely. Simultaneously close the flow clamp on the nearly
empty container and open the flow clamp on the second container.
(b)
Adjust the drip rate, as ordered.
(c) Disconnect the tubing from the nearly empty container with a
twisting motion, being careful not to contaminate the tubing.
(d) Hang a new reserve container on the IV pole and insert the tubing,
maintaining asepsis.
(e) Discard the empty container appropriately.
(f) As the irrigating solution containers become nearly empty, repeat
the exchange procedure in order to maintain a constant flow of irrigation solution.
c. Follow-Up Phase.
Observe special considerations while performing continuous irrigations:
(1) Always have a second container of irrigating solution available to replace
the one that's nearly empty.
(2) Check the inflow and outflow lines periodically for kinks, to make sure
the solution is running freely.
(3)
Measure the outflow volume correctly.
(a) Outflow volume should equal or, allowing for urine production,
slightly surpass inflow volume.
(b) If inflow volume exceeds the outflow volume, suspect bladder
rupture or renal damage, and notify the professional nurse immediately.
(4)
Assess outflow for blood clots and/or changes in appearance.
MED918
2-26