🛏️ “Proper positioning ensures comfort, promotes healing, and enhances care.”
🗨️ Positioning refers to placing a patient in a specific posture to achieve comfort, therapeutic benefit, or procedural need.
✅ It helps in:
🛏️ Lying flat on the back with arms at sides
🩺 Used For:
✔️ Rest, sleep
✔️ Postoperative recovery
✔️ Abdominal & frontal chest exam
✔️ ECG, catheterization
🛏️ Lying flat on the stomach, face down
🩺 Used For:
✔️ Spinal surgeries
✔️ Promotes drainage from mouth
✔️ COVID-19 respiratory therapy (prone ventilation)
🛏️ Patient lies on left or right side
🩺 Used For:
✔️ Promotes sleep & pressure relief
✔️ Rectal examination, enema
✔️ Pregnant women (left lateral improves circulation)
🛏️ Head of bed elevated (3 types):
| 🎚️ Degree | 📏 Type | 📌 Purpose |
|---|---|---|
| 90° | High Fowler’s | Respiratory distress |
| 45–60° | Standard Fowler’s | Post-op, NG tube insertion |
| 30–45° | Semi-Fowler’s | Tube feeding, cardiac patients |
🛏️ Half-prone, left side-lying with right knee flexed
🩺 Used For:
✔️ Rectal exams
✔️ Enemas
✔️ Unconscious patient positioning
🛏️ Head lower than feet, flat bed tilted
🩺 Used For:
✔️ Hypotension, shock
✔️ Venous return improvement
✔️ Central line insertion
🛏️ Feet lower than head
🩺 Used For:
✔️ Gastrointestinal reflux
✔️ Certain surgeries
✔️ Head trauma patients (to reduce ICP)
🛏️ Lying on back with legs raised in stirrups
🩺 Used For:
✔️ Vaginal delivery
✔️ Pelvic exams
✔️ Perineal surgeries
🛏️ Kneeling with chest touching bed
🩺 Used For:
✔️ Rectal exams
✔️ Spinal correction (e.g., infant with spina bifida)
✔️ Some gynecological procedures
🛏️ Similar to lithotomy, but more relaxed for minor procedures
✅ Q: Which position is best for respiratory distress?
🅰️ High Fowler’s
✅ Q: In which position is an enema given?
🅰️ Left lateral or Sims’
✅ Q: Trendelenburg position is useful in…?
🅰️ Shock or hypotension
✅ Q: Which position is used for gynecological exams?
🅰️ Lithotomy
✅ Q: What position reduces risk of aspiration during feeding?
🅰️ Semi-Fowler’s
📌 “The right position makes the procedure safe, effective, and comfortable.”
🗨️ Positioning for procedures refers to placing the patient in an optimal posture to facilitate medical or nursing interventions, ensuring safety, visibility, and comfort.
📍 Position: High Fowler’s (90° sitting)
✅ Ensures proper passage through esophagus
✅ Reduces aspiration risk
📍 Position: Left lateral (Sims’)
✅ Uses gravity to aid flow into descending colon
✅ Promotes retention of solution
📍 Position: Left lateral with upper leg flexed (Sims’)
✅ Relaxes rectal sphincter
✅ Easier access
📍 Position: Lithotomy
✅ Maximum exposure of vaginal canal
✅ Relaxed thigh & perineum muscles
📍 Position: Dorsal Recumbent (flat on back, knees bent, legs apart)
✅ Provides access to urinary meatus
📍 Position: Supine (flat on back)
✅ Straight alignment of urethra
📍 Position: Right lateral (lying on right side)
✅ Applies pressure on liver to prevent bleeding
📍 Position:
✅ Widens space between vertebrae
✅ Easier needle insertion
📍 Position:
✅ Opens up pleural space
✅ Prevents injury to lungs
📍 Position: Supine with legs abducted (using pillow or wedge)
✅ Prevents hip dislocation
📍 Position: Depends on lung lobe
✅ Trendelenburg or side-lying as per segment being drained
📍 Position: Semi-Fowler’s (30–45°)
✅ Reduces aspiration risk
📍 Position: Supine with arm raised behind head
✅ Flattens breast tissue for palpation
📍 Position: Dorsal Recumbent or Lithotomy
✅ Allows easy cleansing and inspection
✅ Q: What is the ideal position for NG tube insertion?
🅰️ High Fowler’s
✅ Q: What position is best after a liver biopsy?
🅰️ Right lateral
✅ Q: Lumbar puncture is done in which position?
🅰️ Side-lying or sitting with back flexed
✅ Q: What position is used for enema administration?
🅰️ Left lateral (Sims’)
✅ Q: Thoracentesis is performed in…?
🅰️ Sitting and leaning forward over a table
💉 “The right position ensures access, safety, and successful surgery.”
🗨️ Surgical positioning refers to the strategic placement of a patient on the operating table to provide the best access to surgical site, maintain physiological function, and ensure patient safety during surgery.
✔️ Provide optimal exposure of surgical site
✔️ Maintain airway and circulation
✔️ Prevent nerve damage and pressure sores
✔️ Maintain body alignment and comfort
🛏️ Patient lies flat on the back, arms at sides or extended
🩺 Used For: ✔️ Abdominal surgery
✔️ Cardiac, thoracic, and facial procedures
✔️ Hernia repair, appendectomy
🧠 Nursing Alert:
🔹 Pad heels, elbows to prevent pressure injuries
🔹 Secure armboards gently
🛏️ Supine with head lower than feet (table tilted)
🩺 Used For: ✔️ Lower abdominal and pelvic surgery
✔️ Enhances visibility by shifting organs upward
🧠 Caution:
🔹 Risk of hypotension, venous congestion
🛏️ Head higher than feet (opposite tilt)
🩺 Used For: ✔️ Upper abdominal surgery (e.g., gallbladder)
✔️ Neurosurgery, thyroidectomy
🧠 Benefit:
🔹 Promotes venous drainage and decreases bleeding
🛏️ Supine with legs raised and supported in stirrups
🩺 Used For: ✔️ Gynecological, perineal, rectal surgeries
✔️ Vaginal delivery, D&C
🧠 Nursing Alert:
🔹 Elevate legs simultaneously to prevent hip dislocation
🔹 Protect peroneal nerves
🛏️ Lying face down, head to one side, arms positioned safely
🩺 Used For: ✔️ Spinal surgery
✔️ Rectal or posterior leg surgery
🧠 Caution:
🔹 Monitor for respiratory compromise
🔹 Protect eyes and face
🛏️ Side-lying with dependent leg flexed
🩺 Used For: ✔️ Thoracotomy, kidney surgery
✔️ Hip or orthopedic procedures
🧠 Nursing Alert:
🔹 Support head, shoulder, and hips
🔹 Protect pressure points (knees, ankles)
🛏️ Head of bed elevated 45–90°
🩺 Used For: ✔️ Neurosurgery (posterior neck, cervical spine)
✔️ Facial or cranial procedures
🧠 Benefits:
🔹 Promotes respiratory function
🔹 Reduces intracranial pressure
🛏️ Prone with hips elevated and head/lower body down
🩺 Used For: ✔️ Rectal surgeries (e.g., hemorrhoidectomy)
🧠 Caution:
🔹 Protect genitals and eyes
🔹 Ensure padding of pressure points
🛏️ Seated with head and upper torso elevated
🩺 Used For: ✔️ Shoulder, neck, cranial surgery
🧠 Risk:
🔹 Hypotension
🔹 Head support is critical
👩⚕️
🔹 Verify surgical site and procedure
🔹 Ensure proper padding and alignment
🔹 Check for circulation and nerve protection
🔹 Assist in safe positioning before anesthesia
🔹 Monitor for pressure areas, injury risk
🔹 Document time, type, and precautions taken
✅ Q: What is the position for spinal surgery?
🅰️ Prone
✅ Q: Which position is used for gynecological procedures?
🅰️ Lithotomy
✅ Q: What is the main risk of Trendelenburg position?
🅰️ Hypotension or venous congestion
✅ Q: Which position is used for rectal surgery?
🅰️ Jackknife (Kraske)
✅ Q: What is the role of padding during positioning?
🅰️ To prevent pressure sores and nerve injury
💧 “Cleanse, relieve, or medicate — the therapeutic power of enema.”
🗨️ Enema is the introduction of fluid into the rectum and lower colon via the anus to stimulate bowel activity, relieve constipation, or administer medication.
✅ It is a nursing procedure used for therapeutic, diagnostic, or surgical purposes.
✔️ Relieve constipation or fecal impaction
✔️ Prepare for surgery or diagnostic tests (colonoscopy)
✔️ Deliver medications (antibiotics, corticosteroids)
✔️ Cleanse bowel before childbirth
✔️ Relieve gas or flatulence
✔️ Reduce body temperature (in high fever — rarely used now)
💡 To clean bowel of feces
| 📦 Type | 💊 Solution Used | 📌 Purpose |
|---|---|---|
| Soap Suds Enema | Soap solution in warm water | Irritates bowel, stimulates peristalsis |
| Saline Enema | Normal saline (0.9% NaCl) | Safest for children/older adults |
| Tap Water Enema | Plain water | Hypotonic — use with caution (risk of water intoxication) |
💡 Fluid is retained in bowel for longer duration (15–30 min)
| 📦 Type | 💊 Solution Used | 📌 Purpose |
|---|---|---|
| Oil Enema | Mineral/olive/castor oil | Softens feces (impaction relief) |
| Medicated Enema | Corticosteroids/antibiotics | Treats inflammation/infection (e.g., ulcerative colitis) |
| Nutrient Enema | Glucose/amino acids | Rare – used when oral feeding not possible |
💡 Used to reduce high fever
💧 Cool water or saline (15°C–20°C)
💡 Used to relieve gas (flatulence)
🧪 Solution: 60–90 mL (1:2:3 ratio of MgSO₄, glycerin, and water)
💡 Used before radiographic exams (e.g., Barium Enema)
✅ Helps visualize colon, rectum, and detect abnormalities
✔️ Enema can with tubing
✔️ Nozzle and clamp
✔️ Lubricant (e.g., petroleum jelly)
✔️ Prescribed enema solution (as per type)
✔️ Kidney tray, Mackintosh, towel
✔️ Gloves and PPE
✔️ Measuring jug and soap
1️⃣ Explain procedure and take consent
2️⃣ Perform hand hygiene and wear gloves
3️⃣ Prepare and warm the enema solution (~37°C)
4️⃣ Position patient in left lateral (Sims’) with right knee flexed
5️⃣ Lubricate the nozzle and insert 7–10 cm (3–4 inches) gently into rectum
6️⃣ Slowly allow solution to flow (use clamp to control)
7️⃣ Instruct patient to retain for 5–15 minutes
8️⃣ Assist to toilet/bedpan, clean perineal area
9️⃣ Document type, amount, and result
🔸 Use caution in:
🔹 Do not give enema:
✅ Q: What is the best position for enema administration?
🅰️ Left lateral (Sims’)
✅ Q: Which enema is best for fecal impaction?
🅰️ Oil retention enema
✅ Q: What is the volume used in adult cleansing enema?
🅰️ 500–1000 mL
✅ Q: Which enema is used to relieve flatulence?
🅰️ Carminative enema
✅ Q: Why is normal saline enema preferred in children?
🅰️ It is isotonic and safe
🔹 Verify doctor’s order and solution type
🔹 Ensure privacy and dignity
🔹 Assess for contraindications (e.g., hemorrhoids, bleeding)
🔹 Maintain asepsis and safety
🔹 Monitor for cramping, discomfort
🔹 Record time, volume given, output, and tolerance
| 🧾 Type of Enema | 💊 Solution Used | 🎯 Purpose | 🧑⚕️ Special Notes |
|---|---|---|---|
| 🧼 Cleansing Enema | Soap suds, tap water, or saline | Remove feces, bowel prep | Adult dose: 500–1000 mL; use warm solution (~37°C) |
| 🪔 Oil Retention Enema | Mineral oil, olive oil | Soften hard stool (impaction) | Retain for 30 minutes for best result |
| 💊 Medicated Enema | Antibiotics (neomycin), steroids | Treat local infection/inflammation (e.g., colitis) | Used in bowel diseases like ulcerative colitis |
| ❄️ Cooling Enema | Cool water or saline (15–20°C) | Reduce high fever (rare today) | Monitor for chilling, not commonly used now |
| 💨 Carminative Enema | 60–90 mL (MgSO₄ + glycerin + water) | Relieve gas and bloating | Retain for 10–15 minutes |
| 🥛 Nutrient Enema | Glucose, amino acids | Provide nutrition rectally (rare) | Temporary use in malnourished or unconscious |
| 🔬 Diagnostic Enema | Barium sulfate | X-ray of colon, rectum | Used in barium enema studies |
✔️ Position: Always administer in left lateral (Sims’)
✔️ Lubrication: Lubricate nozzle before insertion
✔️ Insertion depth: 3–4 inches (7–10 cm) for adults
✔️ Retention time: Varies by enema type (5–30 minutes)
✔️ Volume: Adults: 500–1000 mL | Children: 100–250 mL
✅ Q: Which enema is preferred for fecal impaction?
🅰️ Oil Retention Enema
✅ Q: What is the position used for enema administration?
🅰️ Left lateral (Sims’)
✅ Q: Which enema is used for diagnostic imaging?
🅰️ Barium (Diagnostic) Enema
✅ Q: What is the effect of carminative enema?
🅰️ Relieves flatulence
✅ Q: What type of enema is used to treat colitis?
🅰️ Medicated enema (e.g., corticosteroids)
💨 “Oxygen is life — administered safely, it saves lives.”
🗨️ Oxygen therapy is the administration of oxygen at concentrations higher than that of ambient air (21%) to treat or prevent hypoxia (low oxygen levels in the blood).
✅ It is a supportive treatment, not curative.
✔️ Treat hypoxemia/hypoxia
✔️ Improve oxygen saturation (SpO₂)
✔️ Reduce work of breathing
✔️ Support patients with respiratory, cardiac, or neurological conditions
✔️ Provide oxygen during surgery, trauma, or resuscitation
🔹 COPD, Asthma
🔹 Pneumonia
🔹 Congestive Heart Failure
🔹 ARDS (Acute Respiratory Distress Syndrome)
🔹 Post-operative recovery
🔹 Cyanosis
🔹 Low SpO₂ (< 92%)
🔸 Untreated pneumothorax
🔸 Caution in CO₂ retainers (e.g., COPD) — avoid high flow
🔸 Avoid near open flames
| 💨 Device | 🔢 Flow Rate | 💯 O₂ Concentration (FiO₂) | 📌 Use |
|---|---|---|---|
| Nasal Cannula | 1–6 L/min | 24–44% | Mild hypoxia, comfort care |
| Simple Face Mask | 5–8 L/min | 40–60% | Moderate hypoxia |
| Venturi Mask | Precise (4–12 L/min) | 24–60% (accurate) | COPD patients |
| Non-Rebreather Mask (NRBM) | 10–15 L/min | Up to 95–100% | Emergency/severe hypoxia |
| Partial Rebreather Mask | 6–10 L/min | 60–80% | Intermediate need |
| Face Tent | ≥10 L/min | 28–100% | Facial trauma, burns |
| T-Piece | ≥10 L/min | 24–100% | Tracheostomy patients |
| Mechanical Ventilator | As set | 21–100% | ICU/ventilator patients |
✅ SpO₂ (Oxygen Saturation): Aim for ≥ 94% (except in COPD: 88–92%)
✅ Respiratory rate, depth, pattern
✅ ABG (Arterial Blood Gas) values
✅ Consciousness level
👩⚕️
🔹 Verify physician’s order (device, flow rate)
🔹 Choose appropriate delivery device
🔹 Check equipment: tubing, humidifier, flowmeter
🔹 Secure oxygen mask/tube properly
🔹 Monitor SpO₂ & RR regularly
🔹 Provide oral and nasal hygiene
🔹 Educate patient/family (no smoking, fire safety)
🚫 No smoking or flames near O₂
🔒 Secure oxygen cylinders upright
💧 Use humidifier for flow >4 L/min
⚙️ Check for oxygen leakage
🧴 Avoid using oils/grease near O₂ equipment
❌ Dry nose/mouth
❌ Headache (if flow too high)
❌ Oxygen toxicity (prolonged high FiO₂)
❌ CO₂ retention in COPD patients
✅ Q: What is the oxygen flow rate for nasal cannula?
🅰️ 1–6 L/min
✅ Q: Which mask provides the most accurate FiO₂?
🅰️ Venturi mask
✅ Q: In COPD, what is the target SpO₂?
🅰️ 88–92%
✅ Q: Which device delivers nearly 100% oxygen?
🅰️ Non-rebreather mask (NRBM)
✅ Q: What is the nurse’s role during oxygen therapy?
🅰️ Monitor oxygen saturation and adjust device as per need
✅ Q: What color Venturi delivers 28% oxygen?
🅰️ White
✅ Q: Which Venturi mask color gives 60% oxygen?
🅰️ Green
✅ Q: Venturi mask is ideal for which condition?
🅰️ Chronic Obstructive Pulmonary Disease (COPD)
✅ Q: What is the flow rate for the blue Venturi adapter?
🅰️ 2–4 L/min
✅ Q: Why is the Venturi mask preferred in COPD?
🅰️ It delivers a fixed and precise oxygen concentration
| 🎨 Color | 💯 FiO₂ (Oxygen %) | 💨 Flow Rate (L/min) |
|---|---|---|
| Blue 🔵 | 24% | 2–4 L/min |
| White ⚪ | 28% | 4–6 L/min |
| Yellow 🟡 | 35% | 8–10 L/min |
| Red 🔴 | 40% | 10–12 L/min |
| Green 🟢 | 60% | 12–15 L/min |
💊 “Feeding vs. Flushing — Know the difference, master the technique.”
🗨️ Introduction of nutrients or medications into the stomach via a tube (e.g., nasogastric, orogastric) in patients unable to take food orally.
🗨️ Washing out stomach contents using fluid via a nasogastric or orogastric tube, commonly in poisoning or drug overdose.
| 💡 Aspect | 🍼 Gastric Gavage | 💧 Gastric Lavage |
|---|---|---|
| 🧠 Purpose | Nutrition, hydration, medication | Remove toxins, blood, poison |
| 👩⚕️ Indications | Dysphagia, coma, surgery, anorexia | Poison ingestion, GI bleeding, drug overdose |
| 🧪 Type of Solution | Nutrient formulas, medications | Warm NS, KMnO₄ (rare), plain water |
| 💉 Equipment | Ryle’s tube, syringe, funnel | Ryle’s tube, irrigation syringe, bucket |
| 🛏️ Position | Semi-Fowler’s (30–45°) | Left lateral (head down if unconscious) |
| 📋 Pre-check | Tube placement, residual volume | Consciousness, gag reflex, contraindications |
| ⏱️ Frequency | As per feeding schedule | Emergency, one-time or repeated till clear |
| ⚠️ Complications | Aspiration, tube blockage | Aspiration, esophageal injury, bradycardia |
1️⃣ Explain procedure & take consent
2️⃣ Check doctor’s order
3️⃣ Assemble articles (Ryle’s tube, syringe, lubricants)
4️⃣ Position patient in Semi-Fowler’s
5️⃣ Insert NG tube, confirm placement (aspiration or auscultation)
6️⃣ Check gastric residual
7️⃣ Administer feed at room temperature slowly
8️⃣ Flush tube with 30 mL water
9️⃣ Clamp tube, document amount & tolerance
1️⃣ Confirm indication (e.g., poisoning)
2️⃣ Wear gloves, gown, mask (PPE)
3️⃣ Place patient in left lateral position
4️⃣ Lubricate and insert Ryle’s tube
5️⃣ Aspirate contents and note color/amount
6️⃣ Instill 200–300 mL warm fluid and aspirate repeatedly
7️⃣ Repeat till return is clear
8️⃣ Send sample if needed for toxicology
9️⃣ Document procedure, patient response
✅ Q: What is the best position for gastric gavage?
🅰️ Semi-Fowler’s
✅ Q: Gastric lavage is contraindicated in…?
🅰️ Corrosive poisoning
✅ Q: Which test confirms NG tube placement?
🅰️ Aspirate pH / auscultation
✅ Q: What solution is commonly used in gastric lavage?
🅰️ Normal saline
✅ Q: Purpose of flushing tube after gavage feeding?
🅰️ Prevent blockage and ensure full delivery
✔️ Verify doctor’s order and indications
✔️ Maintain aseptic technique
✔️ Monitor vital signs, nausea, abdominal distension
✔️ Ensure correct tube placement
✔️ Prevent aspiration and discomfort
✔️ Educate patient/family on home care if long-term use
🛏️ “Right size, safe feed — precision in every procedure.”
🗨️ Feeding tubes are flexible tubes inserted into the stomach or intestine to provide nutrition, fluids, or medications when oral intake is not possible.
✅ Tubes are measured using French (Fr) scale, where 1 Fr = 0.33 mm diameter.
| 👶👨🦳 Patient Type | 📐 Tube Size (Fr) | 🔄 Length | 🛏️ Use/Route |
|---|---|---|---|
| Neonates (0–28 days) | 5–8 Fr | 36–42 cm | Nasogastric/Orogastric |
| Infants (1–12 months) | 6–10 Fr | 42–55 cm | NG/OG tube for feeding |
| Children (1–12 years) | 8–12 Fr | 50–75 cm | NG tube for feeding/meds |
| Adolescents & Adults | 12–16 Fr | 90–120 cm | NG/NJ tube feeding or medication |
| Gastric Lavage (Adults) | 16–18 Fr | 105–120 cm | Emergency use (poisoning) |
| Gastrostomy/PEG Tube | 14–24 Fr | Customized | Long-term feeding |
| 🧪 Tube Type | 📏 Common Sizes | 💡 Purpose |
|---|---|---|
| Ryle’s Tube (NG) | 12–16 Fr (adults) | Short-term feeding, suction |
| Orogastric Tube (OG) | 5–12 Fr | Neonatal/ICU feeding |
| Nasoduodenal / Nasojejunal (ND/NJ) | 6–12 Fr | Post-pyloric feeding |
| Gastrostomy Tube (G-tube) | 14–24 Fr | Long-term direct gastric feed |
| Jejunostomy Tube (J-tube) | 6–12 Fr | Long-term post-gastric feeding |
✔️ Patient’s age & condition
✔️ Purpose (feeding vs. lavage vs. decompression)
✔️ Viscosity of formula/medication
✔️ Duration (short-term vs. long-term)
✔️ Route (nasal, oral, PEG, etc.)
👩⚕️
🔹 Choose correct size as per doctor’s order & patient’s profile
🔹 Ensure tube is well-lubricated and correctly placed
🔹 Secure the tube with tape or holder
🔹 Check for patency and residual volume
🔹 Monitor for irritation, aspiration, dislodgement
✅ Q: What is the standard NG tube size for an adult?
🅰️ 12–16 Fr
✅ Q: What size tube is used for gastric lavage in adults?
🅰️ 16–18 Fr
✅ Q: What is the unit for measuring feeding tubes?
🅰️ French (Fr)
✅ Q: Which feeding tube is used for long-term enteral feeding?
🅰️ Gastrostomy or PEG tube
✅ Q: NG tube for a neonate is usually…?
🅰️ 5–8 Fr
🛏️ “Drain with dignity — safe catheter care is essential to restore comfort.”
🗨️ Urinary catheterization is the insertion of a sterile tube (catheter) into the bladder through the urethra to drain urine for diagnostic, therapeutic, or monitoring purposes.
✔️ Relieve urinary retention
✔️ Monitor urine output (critically ill patients)
✔️ Collect sterile urine sample
✔️ Pre-op & post-op care
✔️ During childbirth or surgery
✔️ For neurogenic bladder or incontinence
| 💉 Type | 📝 Description | 🧪 Use |
|---|---|---|
| Indwelling (Foley) | Left in place, balloon at tip | Long-term drainage |
| Intermittent (In & Out) | Temporary, no balloon | One-time urine drainage |
| Suprapubic | Inserted through abdomen | Long-term use, surgical |
| Condom catheter | External (for males) | Non-invasive, incontinence |
| 👶👩🦳 Patient | 📐 Size (Fr) | 🧪 Use |
|---|---|---|
| Children | 6–10 Fr | Pediatric catheter |
| Females (adult) | 12–14 Fr | Routine catheterization |
| Males (adult) | 14–18 Fr | Routine catheterization |
| Irrigation / Hematuria | 20–24 Fr | 3-way catheter (TURP care) |
✅ 1 Fr = 0.33 mm diameter
🔹 Sterile catheter (right size)
🔹 Catheterization tray (sterile)
🔹 Antiseptic solution & swabs
🔹 Sterile gloves
🔹 Lubricant jelly
🔹 Urine collection bag
🔹 Adhesive tape
🔹 Towel, drapes, Mackintosh
🔹 Syringe with sterile water (for balloon inflation)
1️⃣ Explain procedure & take consent
2️⃣ Position in dorsal recumbent position
3️⃣ Perform hand hygiene & wear sterile gloves
4️⃣ Clean perineum front to back using antiseptic
5️⃣ Lubricate catheter tip
6️⃣ Gently insert catheter 2–3 inches until urine flows
7️⃣ Inflate balloon (if Foley) with 10 mL sterile water
8️⃣ Secure catheter and connect to urine bag
9️⃣ Document date, time, size, output & tolerance
📍 Differences:
🔹 Hold penis at 90° angle
🔹 Insert catheter 6–8 inches
🔹 Be gentle to avoid urethral trauma
🚫 UTI (Urinary Tract Infection)
🚫 Urethral trauma or bleeding
🚫 Catheter blockage or kinking
🚫 Leakage around catheter
🚫 False passage formation (especially in males)
✔️ Use aseptic technique
✔️ Check for latex allergy
✔️ Monitor urine color, clarity, volume
✔️ Maintain closed drainage system
✔️ Provide perineal hygiene twice daily
✔️ Label, date, and document properly
✔️ Remove catheter as early as possible to reduce UTI risk
✅ Q: What is the standard catheter size for adult females?
🅰️ 12–14 Fr
✅ Q: Which position is used for female catheterization?
🅰️ Dorsal recumbent
✅ Q: Which catheter is used for bladder irrigation?
🅰️ Three-way Foley catheter
✅ Q: What is the balloon inflation volume for a Foley catheter?
🅰️ 10 mL sterile water
✅ Q: Which complication is most common with long-term catheter use?
🅰️ Urinary tract infection (UTI)
💧 “Flush to restore — clearing clots, preventing blockages.”
🗨️ Bladder irrigation is the instillation of sterile fluid into the bladder via a catheter to prevent or treat blockage, remove clots, or deliver medications.
✅ Commonly used after urological surgeries (e.g., TURP).
✔️ Remove blood clots, debris, or pus
✔️ Maintain catheter patency
✔️ Prevent/treat infection or blockage
✔️ Administer antiseptic or antibiotic solutions
✔️ Postoperative care for bladder or prostate surgery
| 💠 Type | 📖 Description | 💡 Use |
|---|---|---|
| Closed Continuous Irrigation (CCI) | Continuous flow via 3-way catheter | Post-TURP to prevent clot retention |
| Intermittent Irrigation | Periodic flushing via syringe | Mild clots or routine flushing |
| Open Irrigation | Syringe used after disconnecting catheter | Infrequent due to ↑ infection risk |
✔️ 3-way Foley catheter (16–24 Fr)
✔️ Irrigation set with sterile tubing
✔️ Irrigation solution (usually NS or RL)
✔️ Irrigation stand or IV pole
✔️ Sterile gloves, apron
✔️ Measuring jug
✔️ Alcohol swabs, tape
1️⃣ Confirm physician’s order
2️⃣ Explain procedure & ensure privacy
3️⃣ Perform hand hygiene, don gloves
4️⃣ Hang sterile irrigation solution at eye level
5️⃣ Connect to 3rd port of 3-way catheter
6️⃣ Regulate flow rate (20–30 drops/min or as ordered)
7️⃣ Monitor outflow for color, clarity, clots
8️⃣ Record input/output balance
9️⃣ Stop if patient c/o pain or bladder distension
🚫 Overdistension of bladder
🚫 Catheter blockage
🚫 Infection due to open system
🚫 Electrolyte imbalance (rare)
🦠 “One catheter, one infection risk — prevent with precision.”
🔸 Prolonged catheterization
🔸 Poor perineal hygiene
🔸 Improper insertion technique
🔸 Open drainage system
🔸 Immunocompromised patients
| 🛡️ Practice | 💬 Description |
|---|---|
| ✅ Aseptic Insertion | Use sterile technique every time |
| ✅ Secure Catheter Properly | To prevent traction and urethral injury |
| ✅ Maintain Closed Drainage | Avoid unnecessary disconnections |
| ✅ Daily Perineal Care | Use mild soap and water — especially after bowel movement |
| ✅ Empty Bag Regularly | Keep bag below bladder level |
| ✅ Avoid Irrigation Unless Ordered | Can introduce infection |
| ✅ Hydration | Encourage fluids (unless restricted) |
| ✅ Timely Removal | Remove catheter ASAP as per protocol |
| ✅ Label & Date Catheter Insertion | Monitor duration and plan removal |
✅ Q: What type of catheter is used in bladder irrigation?
🅰️ Three-way Foley catheter
✅ Q: What solution is commonly used for bladder irrigation?
🅰️ Normal saline
✅ Q: What is the most common complication of catheter use?
🅰️ Urinary tract infection (UTI)
✅ Q: Best method to prevent UTI in catheterized patients?
🅰️ Maintain closed sterile drainage system
✅ Q: When should a catheter be removed?
🅰️ As soon as clinically no longer needed