ENEMA

• A common procedure to relieve constipation or evacuate the lower bowel is an

enema, the installation of solution into the rectum and sigmoid colon.

A. Purpose

• Bowel preparation for diagnostic tests • To soften the stool ( oil-retention )

or surgery to empty the bowel of fecal • To relieve gas ( tidal, milk and
content
molasses, or fleet’s enema )

• Delivery of medication into the colon • Promote defecation and evacuate

( such as enemas containing neomycin feces from the colon of patient with
to decrease the bowel’s bacteria count constipation and impaction.

or kayexalate exam to decrease the
serum potassium level )

B. Equipments

• Prepackaged enema or enema • Bath blanket

container
• Bedpan or commode

• Disposable gloves
• Washcloth and towel

• Water-soluble jelly
• Basin

• waterproof pad
• Toilet tissue


C. Types

• Cleansing Enema – This type of enema prevent the release of feces while the
patient is in surgery. The process prepares the intestines of the patient for a
colonoscopy or x-ray. This type of enema can be administered as a small volume
or large volume cleansing enema.

• Carminative Enema – This type of enema releases tension or swelling in the colon
and rectum. When waste builds and sits in the colon, a carminative enema allows
the waste and toxins to leave the body.

• Retention Enema – This type of enema is used to administer medication and oil
into the patient’s rectum. The types of oil and medications include nutritive,
antibiotics, and anthelmintics.

• Return-Flow Enema – This type of enema provides an alternating flow of enema

solutions between 100 and 200 mL into and out of the patient’s colon and rectum
to stimulate peristalsis to propel food along the normal process.

D. What affects the force of the solution?

- the force is determined by the height at which the solution is hung. Excessive
pressure can force colonic bacteria into the small intestine or may rupture the colon.
The client should be placed in sim’s position with the anus exposed to facilitate the
flow of solution by gravity into the defending colon.

E. What affects the time of administration?

- Client is advised to retain solution for 5-10min to promote peristalsis.

F. What affects the time of retention?

- The amount of time usually allow muscular contraction to be come sufficient to

produce good result.

G. NSG RESPONSIBILITIES

BEFORE:

- the nurse is to check the physicians order

- the nurse must be familiar with the various kinds of enemas that may be
ordered, their purpose and administration -

- check patient’s ability to retain fluid and tolerate the activity ordered, their
purpose and administration

- determine the presence of kidney or cardiac disease

DURING:

- the nurse should explain the correct procedure to the patient

- assist the adult client to a left lateral position, with the leg as acutely flexed as
possible

- nurse must see to it that enema is administered to the correct patient

- encourage the patient to retain fluid as long as possible

- assist the patient to the bed pan

AFTER: - observe and evaluate results

-record in the patient’s chart the type of enema administered

amount of fluid instilled and the time it was given