Question about manual irrigation for 3 way foley!!

LovingLife123 · Mar 3, 2019

There not a lurelock on it? I always thought a three way was the one with the temp probe.

Ive always attached saline to the lurelock and flushed. Why would you pull back?

I just flushed my catheter today numerous times and it sounds nothing like what you are doing. But, perhaps this is a much different foley.

Editorial Team / Admin · Mar 3, 2019

12 minutes ago, LovingLife123 said:
There not a lurelock on it? I always thought a three way was the one with the temp probe.
Ive always attached saline to the lurelock and flushed. Why would you pull back?
I just flushed my catheter today numerous times and it sounds nothing like what you are doing. But, perhaps this is a much different foley.

A three-way foley refers to one that allows irrigation. A temperature sensing foley is not the same as a three-way. Three-way foleys allow continuous bladder irrigation and can often be seen after bladder/prostate procedures (TURBT, TURP, etc). There is the port to inflate the balloon, a port that connects to the drainage bag, and a port that connects to fluid for the irrigation.

@Race881, your best bet is to refer to your facility's procedures for the appropriate way to do the intermittent irrigation.

brownbook · Mar 3, 2019

Your question is not dumb. There may be nurses on All nurses who have worked 30 years on a urology unit and they would not know. Procedures change, equipment changes, how things were done 10 years ago, or 10 weeks ago, changes.

The correct answer is check the policy....BUT policy books are not readily accessable and seldom give specific instructions.

Some options are ask the nurse who gives you report. DON'T feel dumb to say..."I haven't irrigated a Foley before, which port do I use..".

Or ask a co-worker or charge nurse.

NO ONE NURSE, or doctor, or even God herself ?, ever knows all the answers. Don't feel dumb to ask.

LovingLife123 · Mar 3, 2019

16 hours ago, Rose_Queen said:
A three-way foley refers to one that allows irrigation. A temperature sensing foley is not the same as a three-way. Three-way foleys allow continuous bladder irrigation and can often be seen after bladder/prostate procedures (TURBT, TURP, etc). There is the port to inflate the balloon, a port that connects to the drainage bag, and a port that connects to fluid for the irrigation.
@Race881, your best bet is to refer to your facility's procedures for the appropriate way to do the intermittent irrigation.

Thanks for that!! I have seen one of those one time. A few years ago. I was actually thinking something completely different. My train of thought was off.

TriciaJ, RN · Mar 4, 2019

I'll tell you how I did it back when: it was done after a TURP and despite CBI the catheter had clotted off. Very important to shut off the CBI at this point because the bladder is getting fuller and fuller. Disconnect the drainage tubing from the catheter itself; have the patient hold it without touching the tip to anything.

With a 50 ml syringe from the irrigation kit, draw up the irrigant (I think we used sterile water) and attach the syringe to the foley. Then slam it in and reef it back out; the force in and out is necessary to dislodge any large clots. Repeat until the foley is once again patent and returns are clear. Reattach the drainage tubing and restart the CBI. Run the CBI at a fairly brisk clip at least to start. The patient may need a B&O supp at this point because it's an uncomfortable procedure.

Of course, do not do any of this without an order on the chart. And do not do any of this if I'm hopelessly outdated or your policy reads differently. I always kept an eagle eye on CBI returns and bumped up the rate if they were redder than Hawaiian punch. Do not be afraid to ask a seasoned coworker to come into the room and help you with the process until you are comfortable with the current way of doing things.

Party_of_five, BSN · Mar 5, 2019

When we hand irrigate we use the irrigation port and then it would drain into the foley bag. Just make sure you are getting what you put in back out. You can use the push-pull method and/or a more forceful flush if there is some slight resistance but don't do it too hard. Watch the pt.

Tron8622 · Mar 6, 2019

The three ports . Saline balloon port usually 30 ml , Foley bag port , and irrigation port . I would just connect the irrigation line to the drain port and bake sure the Foley is draining and getting less bloody. You only draw back if your not getting Foley bag drainage . I would stop irrigation and use a irrigation syringe to flush and draw back for usually clots clogging the Foley . But the main goal is to prevent clots and urine drainage