Administering an Enema

Introduction

• Purpose: Used to treat constipation or prepare the bowel for procedures.

Preparation

• Introduce Yourself: State your name and confirm the patient's name, type of enema, and time of administration.
• Verify Details: Match patient record with enema solution/package label. Check medicated enema accuracy against provider’s order.
• Identify Patient: Use two identifiers (e.g., name, birth date).
  • Example: "Please state your name" - Juana Hankins, "And your birthday" - 7/4/70.
• Privacy: Draw curtains or close the door, raise bed to comfortable height, and ensure side rail on left side is up.
• Positioning: Assist patient into left side-lying (Sims) position with right knee flexed. Cover with bath blanket, exposing only anal area.

Equipment

• Gloves: Apply clean gloves.
• Bedpan/Commode: Position nearby. Ensure bathroom is unoccupied and patient has slippers and robe ready.

Administering a Pre-Packaged Disposable Enema

1. Prepare Enema: Remove plastic cap and apply water-soluble gel to pre-lubricated tip.
2. Inspect Area: Place waterproof pad under hips/buttocks, separate buttocks, and check for abnormalities.
3. Insert Tip: Expel air from container, insert tip gently toward umbilicus, adjusting depth by age. Do not force if resistance is felt—contact healthcare provider.
4. Administer Solution: Roll bottle to instill solution, use toilet tissue to press around rectal tube and withdraw it.
5. Encourage Retention: Instruct patient to retain enema for 2-5 minutes.

Administering an Enema Using an Enema Bag

1. Prepare Solution: Fill bag with warm water or saline (check temperature on wrist). Mix with Castile soap if prescribed.
2. Expel Air: Raise bag, release clamp to flow solution until tubing fills, then re-clamp.
3. Insert Rectal Tube: Apply water-soluble gel, gently insert into anus and adjust depth based on patient age.
4. Control Flow: Open clamp, keep container at hip level, gradually raise for different enema heights (high: 12-18 inches, regular: 12 inches, low: 3 inches).
5. Completion: Once instilled, clamp tube, use toilet tissue to withdraw tube.

Post-Procedure

• Patient Instructions: Explain mild bloating and cramping are normal, retain solution, and assist to commode or bedpan.
• Observation: Observe stool characteristics but prevent patient from flushing until inspection.
• Clean Up: Help wash with soap and water, discard gloves, perform hand hygiene.
• Assessment: Check abdomen for distension. If for constipation relief, ask if symptom subsides.
• Documentation: Record enema type, volume, administration time, stool characteristics, and patient’s tolerance.

Follow-Up Care

• Comfort: Position patient comfortably and explain how to summon assistance.