Enema Definition Enema is an activity inserting the

Definition Enema is an activity inserting the liquid slowly into the rectum and colon

The aims of giving enemas are: 1. To stimulate peristaltic bowel and to defecate

CONTRAINDICATION Diverticulitis Ulcerative Colitis Crohn’s Disease

PRINCIPLES 1. The amount of enema liquid given depends on the types of enema,

ASSESSMENT 1. Review the status of the client; bowel sounds, level of consciousness, the

PRAINTERACTION (preparation of nurses and equipment) NURSES : • Wash hands • Review the

Prepare tools and put it close to a client's bed • disposable gloves •

ORIENTATION (prepare client): • Explain the reasons and procedures • keep the privacy of

IMPLEMENTATION • Install rubber sheet and saucer and Bedpan put close to the client

CONTINUE • If you are finished, gently pull cannula • Instruct the client to

EVALUATION • Evaluate and document of activities, including the type and volume of the

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Enema

Definition Enema is an activity inserting the liquid slowly into the rectum and colon via the anus with a rectal cannula.

The aims of giving enemas are: 1. To stimulate peristaltic bowel and to defecate to overcome constipation and impaction 2. To clean the colon in preparation for surgery or diagnostic 3. To clean therapy.

CONTRAINDICATION Diverticulitis Ulcerative Colitis Crohn’s Disease

INDICATION Constipation Feces Impaction

PRINCIPLES 1. The amount of enema liquid given depends on the types of enema, purposes of enema, age and ability of the client. 2. Enema is given at a quite warm temperature 40. 5 to 43 C (adult), 37 C (child) 3. The frequency of enemas which is given too often can damage the normal defecation reflex 4. Too much liquid soap can irritate the colonic mucosa

ASSESSMENT 1. Review the status of the client; bowel sounds, level of consciousness, the pattern of defecation, mobilization, the existence of hemorrhoids and external spingter control 2. Examine the needs of clients to the enema 3. Determine the type and size of cannula enema 4. Determine the client's level of understanding about the purpose of the enema

PROCEDURE OF ENEMA

PRAINTERACTION (preparation of nurses and equipment) NURSES : • Wash hands • Review the status of client

Prepare tools and put it close to a client's bed • disposable gloves • enema containers, tubes + clamp and rectal cannula sizes Fr : 22 -30 (adult), Fr 12 -18 (children) or a package with a rectal enema tip • enema liquid, jelly • rubber sheet and saucer, bath blanket, tissue and bengkok • The basin, wash lap, soap, and towels • Bed pan

ORIENTATION (prepare client): • Explain the reasons and procedures • keep the privacy of client: close the door, open required rectal area • Provide a comfortable position. adjust the position of the client: the left side or Sim's position with your right knee flexion

SIM POSITION

IMPLEMENTATION • Install rubber sheet and saucer and Bedpan put close to the client • put on the gloves, prepare the enema sets, lubricate the cannula tip with jelly 7. 5 -10 cm • Determine the location of the anus with a non-dominant hand • Insert the tip of the cannula slowly, 7. 5 -10 cm (Adult), 57. 5 cm (the children). suggest the client to relax and breath deeply • Flow the enema liquid by opening clamps and raise the container slowly: 30 -45 cm (high enema)

CONTINUE • If you are finished, gently pull cannula • Instruct the client to hold 5 -10 minutes or according to client's ability (for children, Squeeze gluteus few minutes) • Help clients defecate and clean • Put the client properly and provide a comfortable position • Collect and clean equipment • Remove gloves and wash hands

EVALUATION • Evaluate and document of activities, including the type and volume of the enema is given, color-number-faecal consistency

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