Enema Administration: Post-Procedure and Variations (Nursing)

by Samantha Rhea, MSN, RN

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    00:05 So, now that we've administered our enema fluid, how long can those even be retained? So, that's going to vary on patient to patient.

    00:12 It's also going to matter depending on the amount of fluid you give to your patient.

    00:17 So, some patients can't retain this fluid for more than maybe a few minutes.

    00:22 They're going to feel some cramping, some pressure.

    00:24 They're going to feel all that fluid and they're going to want to evacuate their bowels.

    00:30 Now, just think about this point the more volume you give to your patient the harder it's going to be for them to retain the enema.

    00:37 If it's a smaller amount, they definitely may be able to hold on to that enema for longer period of time.

    00:44 Now, the average here again, it's hard to say, it's going to vary patient to patient and of course volume.

    00:50 But 15 minutes is pretty common and if you're talking about a small amount of fluid, maybe even an hour.

    00:57 So, during this time as you can imagine, the patient needs some breathing and some distraction techniques, to help them retain the fluid as long as possible.

    01:06 And again, hopefully that enema is productive, So, they may need to evacuate their bowels more than once, so, keep those supplies nearby.

    01:16 Now, after we get done, we want to make sure we assist that patient either to a bedside commode or a bedpan for a patient.

    01:24 So, I'll be honest with you a lot of the times, there's so much pressure, your patient may not be able to get it to the bathroom.

    01:30 So, have an alternative device, such as your commode or your bedpan.

    01:35 Now, once the patients evacuated the fluid, this is a great time to assist them in perineal care as needed, then you can remove your gloves and of course perform hand hygiene.

    01:46 Before we leave the room, don't forget to place the bed in the lowest position, make sure the patient's comfortable, clean, dry, perform hand hygiene and document the procedure.

    02:03 Now, with enema administration, we need to ask the question, how long are those enemas retained? So, as you know some patients are not able to retain that fluid for very long, maybe just a few minutes.

    02:15 And as you can imagine, especially with the enema bucket administration, you can imagine there's a lot of fluid going in and there could be some pressure and some cramping and obviously the patient's going to want to have the urge, to evacuate their bowels.

    02:30 So, if this is the case and you feel like your patient can't retain a large volume enema.

    02:35 Collaborate with your healthcare provider and there's some other great options.

    02:39 So, let's talk about a few of those.

    02:41 So, here are some smaller volume options.

    02:44 So, this one's about like a 133 ml about 4.5 ounces of sodium phosphate enema.

    02:50 This is a very common in administration and sometimes, you can even find about this volume over the counter.

    02:58 Now, sometimes your patient may need a smaller volume even from that.

    03:02 We have these really tiny yet effective enema administrations about this size.

    03:09 This is about 7.5 ml here or about a quarter of an ounce of liquid glycerin.

    03:15 Now again, enemas are a great option but sometimes, we may need to pull something else out and try another option.

    03:22 Here, we have a medicated laxative suppository.

    03:26 These can also be really effective in producing a bowel movement.

    03:30 Now, with enemas again, just remember this can be a little bit uncomfortable and you may need to give breathing or distraction techniques, for your patient to retain the fluid as long as possible Next, just know any time you're giving an enema, the patient may need to evacuate their bowels more than once.

    03:51 So, keep a bedside commode or a bedpan nearby, if that's the case we had really successful results.

    03:59 So again, after administration, make sure the patient had a bedside commode or bedpan ready.

    04:05 Then once we've done that and we've had a productive result, make sure you provide perineal care for your patient and of course, remove your gloves and hand hygiene and thank your patient, thanks guys, for watching today.

    04:24 Looking at some special considerations regarding enema administration, let's talk about a few of those.

    04:30 So, cramping or discomfort is actually a pretty common potential complication.

    04:36 So, this makes a lot of sense, but one easy way to maybe prevent this, sometimes that enema fluid is going in a little too fast, we could slow this down and communicate with your patient to prevent this.

    04:49 Now, because the influx of fluids, sometimes the patient can feel a little dizzy or faint.

    04:54 So, we need to watch for this.

    04:56 And again, communication throughout the enema administration will definitely help.

    05:02 Let's talk about a couple more points here before we go.

    05:05 So, when we insert the enema tip in particular, we can stimulate a vagus nerve and it cause that heart rate to slow down.

    05:14 So, you can imagine this can be concerning and cause dizziness and faintness as well.

    05:19 And lastly, we talked about this about lubricating the catheter, be careful about insertion, we definitely can cause trauma to the GI mucosa.

    05:28 So, we need to be cautious on insertion and administration here.

    05:32 Thanks for stopping by guys and thanks for watching.

    About the Lecture

    The lecture Enema Administration: Post-Procedure and Variations (Nursing) by Samantha Rhea, MSN, RN is from the course Enema Administration (Nursing).

    Included Quiz Questions

    1. The comfort of the client during administration and the amount of administered enema solution.
    2. The temperature of the enema solution and the amount of administered enema solution.
    3. The comfort of the client during administration and the client's bladder volume during administration.
    4. The amount of administered enema solution and the client's body positioning.
    1. Medicated laxative suppository
    2. Soap-suds enema
    3. fleet enema
    4. Sodium phosphate enema
    1. Stop the enema administration and check the client's vital signs.
    2. Instruct the client to take slow deep breaths.
    3. Withdraw the enema tubing by 1 inch.
    4. Increase the rate of enema administration, so the procedure is completed faster.

    Author of lecture Enema Administration: Post-Procedure and Variations (Nursing)

     Samantha Rhea, MSN, RN

    Samantha Rhea, MSN, RN

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