- Slides: 26
ADMINISTERATION OF AN ENEMAS
An enema Enema administration is a procedure used to introduce fluid into the lower bowel (the rectum and sigmoid colon) through anus. The purpose of an enema is �To cleanse the lower bowel. �To assist in the evacuation of stool or flatus. �To instill medication, nutrition or barium.
Cleansing enema � Is the most common type of enema. �This type of enema stimulates peristalsis via irritation of the colon/rectum and by causing intestinal distention with fluid.
Type of solutions used for enemas � 1 - Tap water � 2 - Normal saline � 3 -Soap solutions � 4 - Oil � 5 -Barium enema solutions (diagnostic). Ø Enemas can be large, small or mini-enemas depending on their purpose.
�Large-volume enemas � It contain 500 to 1000 m. L fluid, are administered to cleanse the bowel. � Caution should be used when administering large volume enemas, because fluid and electrolyte imbalance can occur. �This is related to the volume, frequency, and type of solution used.
Small-volume enemas : Are used for the purpose of evacuating stool or instilling medications in the lower bowel. � These are usually found as prepackaged solutions, which contain 150 to 240 ml fluid. �Mini-enemas: � Usually contain 4 to 10 ml liquid. �Clients should be instructed to call for assistance immediately if light-headedness, dizziness, or faint feeling occur.
�Equipment : �Absorbent pad for the bed � Disposable gloves � Lubricant. �Solution per physician’s order �Enema container , or Prescribed prepackaged enema or Enema bag �Tubing with clamp. � Toilet tissue �Towel. �Bedpan, commode, or toilet
�ACTION: � 1. Assess client’s understanding of procedure and provide privacy. � 2. Wash hands. � 3. Apply gloves. � 4. Prepare equipment(Prepare the solution, assure temperature within range of 99° to 102°F by using a thermometer or placing a few drops on your wrist.
� 5. Place absorbent pad on bed under client. Assist client in attaining left lateral position with right leg flexed as sharply as possible.
� 6. Pour solution into the bag or bucket; add water if needed. � 7. Open clamp and allow solution to prime tubing. Clamp tubing.
� 8. Lubricate 5 cm (2 inches) of the rectal tube � 9. Separate buttocks, Slowly and smoothly insert rectal tube into rectum approximately 7– 10 cm in an adult. , have the client take a deep breath.
� 10. Raise the container holding the solution and open clamp. The solution should be 30– 45 cm (12– 18 inches) above the rectum for an adult, and 7. 5 cm (3 inches) above the rectum for an infant.
� 11. Slowly administer the fluid. � 12. When solution has been completely administered or when the client cannot hold any more clamp the tubing and remove the rectal tube, disposing it properly
� 13. Clean lubricant, any solution, and any feces from the anus with toilet tissue. � 14 - In barium studies x-rays films are followed.
� 15. When the client has retained the enema for the prescribed amount of time, assist to the bedside commode or toilet or onto the bedpan. �If the client is using the bathroom, instruct not to flush the toilet when finished
� 16. When the client is finished expelling the enema, �assist to clean the Perineal area if needed. � 17. Return the client to a comfortable position. �Place a clean, dry protective pad under the client to catch any solution or feces that may continue to be expelled.
� 18. Observe feces and document data. � 19. Remove gloves and wash hands
�Small Volume, Prepackaged Enema : �Remove the protective cap from the nozzle (for mini- enemas tip needs to be punctured with needle or pin). �Lubricat the nozzle � Squeeze the container gently to remove any air and prime the nozzle.
�Enemas are contraindicated in: � 1 -Bowel obstruction � 2 - Inflammation , or infection of the abdomen � 3 -If the client has had recent rectal or anal surgery.