Today is our topic of discussion General Instruction for Enema.
General Instruction for Enema
General Instruction
- The appropriate size of rectal catheter or rectal tube of cleansing enema is 22 French for adults, 12 French for infant and 14 to 18 French for children (School-age child) .
- The rectal tube need to the smooth and flexible.
- The rectal tube is lubricated with a water soluble lubricant or vaseline to facilitate insertion and to decrease irritation of the rectal mucosa (Fig. 16.5) .
- The temperature of the solution needs to be adjusted according to the purpose of the enema.
- The amount of the solution to be administered depends up on the type of enema and the age and size of the person .
- The patient usually placed in left lateral position, when an enema is administered. In this position, sigmoid colon is below the rectum, thus facilitating instillation of the fluid.
- The distance to which the tube is inserted depends upon the age and the size of the patient. For an adult it is normally inserted 7.5 to 10 cm (3 to 4 inches), for children it is 2.5 to 3.75 cm (into 1 ½ inches).
- The height of the enema can should not be above 18 inches (20 cm) from the anus.
- The length of time that the enema solution is retained will depend up on the purpose of enema oil retention enema are usually retained for 2 to 3 hours. Other cleansing enemas are normally retained 5 to 10 minutes.
- Prepacked enema will have their own instruction which need to be followed.
- Prevent air from entering into rectum, by expelling air from the tube.
- If the rectum is impacted, attempt to remove the fecal matter with a gloved finger .
- Make sure the whole apparatus use for the administration of enemas is in a good working condition.
- Regulate the flow of fluid according to the type of enema.
- Listen to the complaints of the patient and should not ignore any discomfort however small they are.
Preliminary Assessment
- Doctors order for any specific precautions
- Diagnosis of the patient
- Abilities and limitations concerning movements
- Level of consciousness to follow directions
- Availability of the articles
- Extra help needed
- Lesions on the rectal and perineal area
- Nature of enema ordered.
Preparation of the Patient and Environment
- Explain the sequence of the procedure
- Arrange the articles at the bed side
- Provide privacy
- Cover the patient with bed sheet .
- Place the Mackintosh and towel under the patient’s buttocks
- Place the patient in the left lateral position
- Keep the bedpan under the bed over a stool
- Adjust the IV pole to hold the enema can at the required height.