Administering Enema
- To evacuate the bowel of stool caused by constipation.
- To cleanse the bowel prior to surgery or other procedures for which the bowel, colon, and rectum are visualized.
- Determine patient’s ability to understand procedure.
- Assess patient’s ability to participate in procedure, such as holding contents when administered.
- Patients who have had recent surgery, or who have arthritis, a cast, lower limb amputations, or fractured pelvis may need additional time for the procedure, owing to limited physical mobility.
- Patients with cardiac history or spinal cord injury may be at risk for complications from vagal stimulation.
- May need more time and instruction of the procedure for optimal participation and results.
- Care should be taken in insertion of the enema tube and instillation of the solution to prevent injury to anus and colon during the procedure.
- Parents should be allowed to comfort infants and children and participate in the procedure.
- Constipation related to decreased peristalsis
- Chronic pain related to abdominal discomfort and distention from bowel malfunction
- Potential for injury related to abdominal distention and trauma to the anus and colon during the procedure
- Patient will return to an optimal bowel elimination pattern
- Patient is able to assist/participate
- Patient will be able to evacuate feces from rectum and colon after the enema
- Patient experiences minimal discomfort during procedure and no injury to the colon and/or anus
- Patient experiences relief and comfort after procedure
- Regular bedpan, fracture pan, or bedside commode
- Water-soluble lubricant
- Clean gloves
- Toilet paper
- Disposable, absorbent bed pads
- Skin care items (i.e., soap or skin cleanser,water, towels)
- IV pole
- Enema container with tubing, normal saline, tap water, soap solution, or commercially prepared enema.
- Check prescriber’s order; identify patient; explain purpose, procedure, and how patient can assist. Assess patient’s ability to participate.
- Confirms order; meets patient’s right to be informed; encourages cooperation and participation.
- Gather all equipment and place in an easy to access area in patient’s room; adjust lighting as needed.
- Explain to the patient the benefits of relaxing and taking periodic deep breaths.
- Wash hands, and don clean gloves.
- After determining patient’s ability to assist, place disposable waterproof pad under patient. Have patient lift hips or roll from side to side.
- Bed pad protects against soiling of linens.
- Place patient in a left side-lying position with knees flexed.
- Place bedpan next to patient.
- Allow the solution to run through the tubing to clear out the air; clamp tubing and hang on an IV pole approximately 12 to 18 inches above the patient’s buttocks.
- Lubricate tip of tubing with generous amount of water-soluble lubricant.
- Spread the buttocks, and gently insert the tip of the tubing 3 to 4 inches while the patient is instructed to take slow deep breaths.
- Open the regulating clamp and allow the solution to flow slowly.
- Hold the tubing in place in the patient’s rectum at all times, and keep the bedpan nearby.
- Lower the solution container or clamp tubing if the patient complains of cramping, then resume after a few minutes.
- After solution is instill, clamp tubing and gently remove.
- Instruct the patient to hold the solution about 10 to 15 minutes or longer as tolerated.
- Provide bedpan or assist to commode as needed.
- Instruct patients with cardiovascular disease not to strain when expelling contents.
- Assist patient with personal hygiene as needed.
- Assist patient back to bed as needed and into a comfortable position.
- Dispose of enema equipment and clean bedpan or bedside commode as needed.
- Remove gloves and wash hands.
- Lubricate tip of enema container as needed (most are prelubricated).
- Spread buttocks and insert the tip into the rectum.
- Gently squeeze entire contents of the container.
- Remove the tip while continuing to squeeze the container.
- Instruct the patient to hold the solution at least 5 to 7 minutes.
- Provide bedpan or assist to commode as needed.
- Instruct patients with cardiovascular disease not to strain when expelling contents.
- Assist patient with personal hygiene as needed.
- Assist patient back to bed as needed and into a comfortable position.
- Dispose of enema equipment, and clean bedpan or bedside commode
- Remove gloves and wash hands.
- Evaluate patient compliance and ability to tolerate procedure
- Administration of an enema is done correctly, safely, and successfully
- An optimal pattern of elimination is maintained or restored
- Record date, time, type, and results of enema administration, as well as amount and other important characteristics of stool (as required in the designated area on the patient record).
- Record patient’s tolerance of procedure and any complications that occurred.
- Report patient teaching about prevention of constipation.
Categories:
Fundamentals In Nursing,
Nursing Procedure
6 komentar:
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