ADMINISTERING AN ENEMA

M. ANUSUYA , B.Sc(N)
Nursing Tutor
KVCN
 Definition
• Insertion of fluid through the patients anus to
cleanse the colon is termed enema.
 Types of enema
Cleansing
enema

Carminative
enema Types Retention
enema

Return-flow
eneama
 purposes
1. To stimulate peristalsis.
2. To promote defecation.
3. To relieve constipation and gaseous distension.
4. To empty the bowel before a diagnostic
procedure.
5. To establish normal bowel function during
bowel training program.
6. To remove the contract medium given during
upper or lower GI series.
7. To reduce fever and cerebral edema.
 contraindications
• Acute renal failure.
• Acute myocardial infarction and cardiac problems
• Appendicitis
• Obstetrical contraindications such as antepartum
hemorrhage and leaking membranes.
• Recent surgical procedure involving lower intestine
tract
• Intestinal obstruction
• Inflammation and infection of abdomen.
Temperature and amount of solution
Age group temperature amount

Adult 105-110 F ( 40-43*c) 750-1000ml

children 100*F (37.1*c) Less than 500ml

 Nursing assessment
A. Assess when the patient had last bowel
movement – the amount, color, and
consistency.
B. Assess for presence of abdominal distension.
C. Assess the ability of the patient to use toilet.
 Preparation of equipements
• A tray containing,
o Disposable gloves
o Water-soluble lubricant
o Bath thermometer
o Soap and water
o Toilet tissue
o Enema can with tubing and glass connection
o Clamp
o Kidney basin – 2 nos
• Iv stand
• Jug with water
• Kettle with warm water
• Solution as ordered.
o Hypertonic – sodium phosphate
o Hypotonic – tap water
o Isotonic –physiological saline ( 1 teaspoon of
table salt in 500ml of tap water)
o Others – 3-5ml of concentrated soap solution in
1000ml of water.
• Mackintosh
• Bedpan- for bedridden patient
• Screen
• Extra linen as per need
 Nursing procedure
 Check the doctors order.
 Assemble all the equipments near the bedside.
 Explain the procedure to the patient.
 Provide privacy.
 Raise the bed to a comfortable working height.
 Wash hands and wear gloves.
 Roll the draw sheet to the opposite side, if there is no mackintosh place one.
 Prepare the solution; attach the rectal tube to the tubing and clamp the
tube.
 Pour the solution into the can; release the clamp; allow the solution to flow
till the tip of the tube, clamp the tube.
 Suspend or hand the enema can with the solution onto the IV stand and
adjust the height to 18 inches above the bed.
 Position the patient in left lateral position. Position the patient near the
edge of the bed.
 Keep the basin over the mackintosh.
 Lubricate 3-4 inches of the rectal tube.
 Using gauze, separate the buttocks; ask the patient
to take a deep breath and insert the rectal tube to a
distance of 3-4 inches; do not force the tube.
 Open the screw or release the clamp.
 Hold the rectal tube in place. Observe the can for the
level of solution.
 If the patient has severe cramps or urge to defecate,
stop temporarily and then continue.
 Once the solution is nearly over, clamp the tube.
 Ask the patient to hold the fluid for 10-
15mints;remove the rectal tube and place it in the k-
basin.
 Assist the patient to toilet or provide bed pan as per
need.
 After defecation, assist the patient to wash the
perineum.
 Reposition the patient comfortably.
 Replace the articles.
 Wash hands.
 Document the procedure.
 record the date, type and volume of the
solution instilled, and characteristics of the
results.
 specify the patients tolerance to the
procedure.
 specify the patients response after the
procedure.
 report any adverse effects.
 Nurses responsibilities
• Inspect color, consistency and amount of stool,
odor, and fluid passed.
• Assess the condition of abdomen.