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ENEMAS
SKILL 28 ADMINISTRATION OF ENEMAS

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SKILL 28
SAFETY

Administration of Enemas
13. Have child take a deep breath. Introduce catheter past anal sphincter into anal canal and lower rectum. Relaxes anal sphincter. 14. Once tip of catheter is in place, elevate bag and instill fluid slowly or squeeze prepackage enema. Do not elevate container more than 10 cm above rectum. Fluid pressure increases with height of bag. 15. If child shows signs of distress, e.g., abdominal pain, shortness of breath, or chest pain, flow should be stopped. 16. When solution is completely administered or child cannot hold any more, clamp tube and remove. 17. Clean lubricant and any feces from anus with toilet paper. 18. Have child try to retain enema for the prescribed amount of time. May hold buttocks together. 19. After prescribed amount of time, place child on bed pan, potty chair, toilet, or apply clean diaper. 20. After child expels the enema, cleanse the anal area as needed. Prevents irritation of skin and mucous membranes of anus. 21. Dispose of equipment in appropriate container. Consistent with body fluid precautions. 22. Remove gloves. Wash hands. Reduces transmission of microorganisms. DOCUMENTATION 1. Procedure, including specific type of enema, and how child tolerated it. 2. Results of enema.

1. Never force catheter into anal canal. If a well lubricated catheter does not advance easily, stop enema. 2. Use only isotonic solutions. 3. Give only the prescribed amount of solution. The smaller the child the less the amount of fluid that can be safely given. 4. Give only the number of enemas prescribed. EQUIPMENT Prepackaged enema or container for enema solution, solution, and rectal catheter Towels Lubricant Bath thermometer Waterproof pad Bedpan, potty chair, diaper, and so forth Gloves, nonsterile PROCEDURE 1. Check physicians order. Ensures appropriate type of enema given. 2. Gather equipment. Promotes organization and efficiency. 3. Wash hands. Reduces transmission of microorganisms. 4. Explain procedure to child and family. Enhances cooperation and participation and reduces anxiety and fear. 5. Fill container with prescribed enema solution, unless it is a prepackaged enema. 6. Warm solution to body temperature or 37.7 C, 100 F. Prevents cramping and discomfort. Cold fluid can cause hypothermia in a small child. 7. Provide for childs privacy. 8. Position waterproof pad under child. Protects bed linens. 9. Position child. a. Left side, lateral recumbent position with knees up to chest. b. On back with legs lifted to expose anal orifice. c. Left side with right leg thigh flexed about 45 to body axis (Sims position). 10. Put on nonsterile gloves. Protects nurse from microorganisms in feces. 11. Lubricate rectal catheter/enema tip. Prevents irritation of mucosal lining of bowel and decreases discomfort. 12. Prime rectal tube or nozzle of prepackaged enema. Avoid introducing air into rectum.

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