Scribd Logo
Upload

Welcome to Scribd!

  • 947 views

    Enema Administration: Size of Rectal Tube

    Uploaded by

    Mabes
    This document provides instructions for administering various types of enemas. It describes the purposes of enemas which include relieving constipation, fecal impaction, and expelling gas. It outlines different types of enemas such as cleaning, high cleansing, low cleansing, oil retention, and medicated enemas. It provides details on equipment needed, solutions used, positions, and procedures for safely administering enemas to patients of various ages. The goal is to empty the bowels while preventing trauma, water intoxication, and electrolyte imbalances.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Enema Administration: Size of Rectal Tube

    Uploaded by

    Mabes
    947 views3 pages
    This document provides instructions for administering various types of enemas. It describes the purposes of enemas which include relieving constipation, fecal impaction, and expelling gas. It outlines different types of enemas such as cleaning, high cleansing, low cleansing, oil retention, and medicated enemas. It provides details on equipment needed, solutions used, positions, and procedures for safely administering enemas to patients of various ages. The goal is to empty the bowels while preventing trauma, water intoxication, and electrolyte imbalances.

    Original Title

    Enema

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document provides instructions for administering various types of enemas. It describes the purposes of enemas which include relieving constipation, fecal impaction, and expelling gas. It outlines different types of enemas such as cleaning, high cleansing, low cleansing, oil retention, and medicated enemas. It provides details on equipment needed, solutions used, positions, and procedures for safely administering enemas to patients of various ages. The goal is to empty the bowels while preventing trauma, water intoxication, and electrolyte imbalances.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    947 views3 pages

    Enema Administration: Size of Rectal Tube

    Uploaded by

    Mabes
    This document provides instructions for administering various types of enemas. It describes the purposes of enemas which include relieving constipation, fecal impaction, and expelling gas. It outlines different types of enemas such as cleaning, high cleansing, low cleansing, oil retention, and medicated enemas. It provides details on equipment needed, solutions used, positions, and procedures for safely administering enemas to patients of various ages. The goal is to empty the bowels while preventing trauma, water intoxication, and electrolyte imbalances.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 3
    At a glance
    Powered by AI
    The passage discusses different types of enemas including cleaning, oil retention, carminative, and medicated enemas. It also outlines best practices for administering enemas including correct volumes, equipment, and positioning.

    The different types of enemas discussed are cleaning enemas, oil retention enemas, carminative enemas, and medicated enemas like sodium polystyrene sulfonate and neomycin.

    Considerations for administering an enema include using the correct volume and temperature of solution, size of rectal tube based on the patient's age, lubricating the tube, slowing introducing the solution, and having the patient change positions if needed.

    ENEMA ADMINISTRATION

    Enema is the instillation of solution into RECTO-SIGMOID COLON


    Action: distends or irritates colon to stimulate peristalsis and promote defecation
    Purposes:
    o to relieve constipation most common problem
    o to relieve fecal impaction
    o to expel flatus
    o to lower body temp
    o to facilitate admin of medications
    o to prepare for diagnostic procedures or surgery
    Types Action Special Consideration
    Cleaning Enema
    NSS
    Tap water
    Hypertonic
    Soap Suds
    Stimulates peristalsis by:
    o irritating the colon or rectum and/
    o distending the colon by the volume of
    solution
    Size of Rectal tube
    Adult: 22-30 Fr
    Children: 14-18Fr
    Infant: 12Fr

    High Cleansing Enema
    o cleans entire colon
    o large volume: 1000ml Adult
    o container height: 12 18 inches
    above rectum

    Low Cleaning Enema
    o cleans rectum and sigmoid colon
    only
    o small volume: 500 adult
    o container height: 12 inches above
    rectum

    WOF complications:
    water intoxication
    electrolyte imbalance
    Soap Suds Stimulates peristalsis by irritating the colon Mild soap (castile soap) + warm water
    Isotonic:
    Normal Saline (NSS)
    0.9%NaCl
    Volume stimulates peristalsis Safest solution
    For infants and children
    Hypotonic: Tap Water Volume stimulates peristalsis Do not repeat water intoxication
    Hypertonic Solution/Fleet
    Enema
    Promotes distention by drawing out water from
    circulating blood volume to the bowel (pulls out
    water into intestines)
    Not for young children and dehydrated
    clients
    Return Flow Enema
    Harris Flush Enema
    Colonic Irrigation
    To expel flatus o 100 200 ml of fluid introduced
    in and out of colon
    o After instilling solution, container
    is lowered so that solution flows
    back into the container
    o Repeat 5 6 x until client expels
    flatus and abdominal distention is
    relieved
    o Replace solution several times as
    it becomes thick with feces
    o Procedure is 15 - 20 minutes
    RETENTION ENEMA
    Oil retention Enema
    Lubricates rectum and colon and softens stool
    (mineral oil, olive oil, or cottonseed)
    Instruct client to retain enema for 1
    3 hours to enhance absorption of oil
    RETENTION ENEMA
    Carminative Enema
    To expel flatus 60 80 ml with combination of
    * 30 ml magnesium
    *60 ml glycerine
    *90 ml water
    MEDICATED ENEMA
    Sodium Polystyrene
    Sulfonate (KAYEXALATE)
    Decreases Potassium levels
    Facilitates exchange of sodium ions for potassium
    ions in large intestines
    For Hyperkalemia
    MEDICATED ENEMA
    Neomycin
    Reduces bacteria in colon prior bowel surgery May cause diarrhea
    Correct Volume of Warmed Solution
    Infant 150 250 ml
    Toddler 250 350 ml
    School Age 300 500 ml
    Adolescents 500 750 ml
    Adults 750 1000 ml

    Size of Rectal tube
    Infant 12 Fr
    Children 14 18 Fr
    Adult 22 30 Fr

    Equipment
    o disposable linen pad
    o bedpan or commode
    o clean gloves
    o water soluble lubricant
    o paper towel

    For Large Volume Enema
    o Correct solution, amount, and temperature (42 C or less)
    o Solution container
    o Rectal tube of correct size
    o Tube clamp
    o IV pole

    For Small Volume Enema
    o Prepackaged container of enema solution with lubricated tip (Fleet Enema)

    Procedure Rationale
    Check the doctors order
    Identify the client, verify, inform, and explain procedure To allay anxiety
    Wash hands and apply clean gloves. observe appropriate
    infection control

    Provide client privacy To prevent feeling of embarrassment
    Promote relaxation To relax anal sphincter and facilitate
    insertion of rectal tube
    Position the client
    Adult: Sims (left-lateral) or left-sidelying with right knee
    flexed

    Infant and Children dorsal recumbent
    Facilitate the flow of solution by gravity as
    sigmoid colon is on left side
    Lubricate the rectal tube about 2 in (5cm)
    Allow solution to flow through connecting tube and rectal
    tube to expel air prior insertion
    Prevents introduction of air in colon
    Insert rectal tube 3 4 inches (7-10cm)
    gently in rotating motion

    Prevent trauma
    Introduce solution slowly
    o raise solution container and open clamp to allow
    fluid to flow
    o High enema 12 to 18 inches above rectum
    To prevent sudden stimulation of peristalsis
    The higher the solution the faster the flow
    and greater pressure in the rectum
    o Low enema 12 inches above rectum

    If client complains of fullness or pain, clamp and stop
    flow for 30 secs and restart at a slower rate
    decrease intestinal spasm and premature
    ejection of solution
    If High Enema change position to distribute solution well
    If Low Enema remain in left lateral
    Left lateral (sigmoid) dorsal recumbent
    (transverse) right sidelying

    If the order is cleaning enema give order 3x alternate
    hypotonic and isotonic
    Prevent water intoxication
    After all solution has been instilled or when client feels
    the desire to defecate, close clamp and remove rectal
    tube, dispose the tube properly

    Encourage client to retain enema, ask to remain lying
    down

    Assist client to defecate in sitting position
    If client is using the toilet, ask not to flush it.
    Observe feces
    Do perineal care
    Make relevant documentation

    You might also like