Enema Administration: Pre-Procedure (Nursing)

by Samantha Rhea, MSN, RN

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    00:04 So, welcome to the skill enema administration.

    00:07 So, let's talk about a few times we're going to need this.

    00:11 So, this is especially important in treating constipation.

    00:15 Now, we may need this if other avenues of helping produce a bowel movement fails.

    00:21 Enema, is usually one of our latter resorts.

    00:24 But, extremely important especially in your post-op or post-surgical patients, that they have a bowel movement to facilitate their recovery.

    00:33 So, let's take a look at enema administration.

    00:37 So, now let's take a look at the solutions that you may need.

    00:40 So, guys there's a whole host of those out there, it could be a saline enema solution, a glycerin, maybe even soap suds.

    00:49 There's all kinds of different pieces out there or different types of medications, so, check your provider's orders.

    00:56 Now, some of these come in a handy-dandy one-step, all-inclusive administration piece.

    01:03 So, what I mean by this if you look at that first image, some of them come in a handheld bottle for home use.

    01:10 Now, sometimes when we give these in the hospital, we may need a different type of solution, therefore, we're going to use a full administration set, so, it's going to have our bucket and also have our catheter.

    01:23 Now next, absorbent pads are really important obviously.

    01:27 You can get a lot of the enema fluid all over the bed, also, if the patient produces results, we're going to need to protect their sheets and their linens.

    01:36 Let's look at some other equipment.

    01:38 Now this is a biggie guys, you want to have a bedpan or a bedside commode already prepared and ready, before you do the enema, so, have this close.

    01:48 Now, if the patient can get to the bathroom, that's great.

    01:51 But many times, when we give a patient an enema, we can't get all the way the bathroom, because the retaining fluid and we'll talk about that soon.

    02:01 Now, next, lubricant is important, because when we insert the catheter, we want to make sure we don't cause trauma to the mucosa.

    02:11 And lastly don't forget to provide thorough perineal care, after the enema administration.

    02:18 Now, the whole goal of this again, it's got to be ordered by a health care provider.

    02:22 So, be conscious that there's different solutions out there and our whole goal is to produce a bowel movement for a patient.

    02:31 Now, before we get started as always, we want to make sure we perform our hand hygiene and absolutely provide privacy for our patient.

    02:39 Now this procedure in particular, is really important to explain to them, because it's a little bit up close and personal.

    02:47 Some patients may find it a little bit embarrassing, but this is perfectly normal when a patient has constipation.

    02:54 Now also, constipation can really cause complications for our patient.

    02:58 So, we want to definitely talk about the benefits of the enema administration.

    03:04 Now, his is a great idea for comfort, because the patient's going to have some pressure with that in the administration, we want to encourage them to go ahead and empty their bladder before we start.

    03:15 And again, don't forget, if we have a bedpan or a bedside commode nearby, we're going to have it handy, when the patient's done with the enema administration and hopefully produce results.

    03:29 Now, let's go ahead and perform our hand hygiene again and we're going to put on our gloves.

    03:34 And of course, we're going to need to get to our patient, so, we want to raise that bed to an appropriate working height.

    03:41 Now, we want to take our enema kit and if we're using a bucket administration, like this, make sure that tubing is clamped and prepare the administration solution.

    03:52 So, let's take a moment here and take a look at this image.

    03:55 So, you see here for gravity purposes, most of the time we're going to have that enema bucket, we're going to hang it on an IV pole for gravity and it's got all this tubing in it and there is a clamp.

    04:08 MAKE SURE guys make sure the tubing is clamped, then we can pour in our solution.

    04:15 If we don't clamp the tubing and pour in the solution and that tubing is open and unclamped, we can lose all of our medication.

    04:24 So be diligent here, to clamp first and then add your medication.

    04:32 So, let's take a look at how we perform our enema administration.

    04:37 So, before we get started, there's a lot of things to consider here.

    04:40 Make sure to perform your hand hygiene and of course, especially with this skill, provide privacy.

    04:47 Now, explaining the procedure to the patient is really critical in this type of skill.

    04:52 You want to make sure you communicate with the patient, you let them know, if there's any discomfort, that you let us know you.

    04:59 You also want to let them know, when the enema administration is flowing and also, how long the patient needs to retain the enema.

    05:07 So, explanation before you start really as a crucial step.

    05:11 Now, here's also a great tip, you want the patient to empty their bladder for comfort if they can beforehand.

    05:18 The reason why I’m saying when we give this enema, you're going to have some excess pressure, so, to help relieve that, if the patient can empty their bladder beforehand that's a great idea.

    05:28 Also, to go ahead and get started, be prepared, so, when we give the patient the enema, they're going to need to evacuate their bowels pretty urgently or to get rid of the fluid.

    05:39 So, have a bedpan by or even a bedside commode.

    05:43 Now, is a great time to go ahead perform our hand hygiene again and put on our gloves.

    05:55 And once we've done that, we want to put our bed to an appropriate working height.

    06:00 Then once we go ahead and prepare our enema kit, we're going to make sure this tubing is clamped, so, I'll walk you through that.

    06:08 So, just know any time that you're working with an enema, there actually may be different type of medications prescribed, this is going to vary depending on the order, so, there's going to be some variations to this.

    06:22 So, let me take my bucket here.

    06:24 This is really common setup when you're using an enema kit.

    06:27 So, you see here it's got this really handy dandy handle, that we can go ahead and put on our IV pole here.

    06:36 This is the tubing piece that comes with it and there's actually a little bitty spicket, if you will, you're just going to make sure that this is seated in well.

    06:47 So, with this once you've attached the tubing, you have the actual enema tip itself.

    06:55 And this is the piece for insertion, also, you've got a clamp here, now, this is really important, that before you put anything in the enema bucket, such as your prescribed medications, this thing's got to be clamped.

    07:10 So, how we do that again is just, you can kind of hear it, make sure that's clamped tightly so that's really important.

    07:18 So, for this particular skill a lot of the times, you're going to get something like this.

    07:23 This is just a simple soap suds enema and again, it's going to vary depending on physician's order.

    07:30 This actually, usually comes with this bucket, so, we'll add this in into some lukewarm tap water, for our patient.

    07:37 So, I'll put this aside.

    07:40 So, we're talking about lukewarm tap water, guys that's really important, the temperature of the water.

    07:46 So, the reason being if I put scolding hot water in here and administer this to my patient I can definitely cause harm.

    07:54 The same thing if it's really cold, you can imagine there's some constriction that could occur, which could also cause issues and complications or even trauma when you try to insert the tip of the tubing itself.

    About the Lecture

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

    Included Quiz Questions

    1. Check the health care provider's prescription to determine the type of enema solution that is required.
    2. Fleet enema
    3. Soap-suds enema
    4. Ask the client which type of enema they would prefer
    1. To optimize client comfort as the client will experience additional pressure with enema administration.
    2. To prevent the client from urinating while attempting to have a bowel movement.
    3. To ensure the enema tubing is inserted into the rectum rather than the bladder.
    4. To speed up the effectiveness of the enema solution.
    1. Close the clamp on the enema tubing
    2. Ensure the enema bag is sterile
    3. Insert the enema tubing into the client's rectum
    4. Hang the enema bag onto a pole
    1. I can offer you a bedpan or bedside commode, so you don't have to walk too far after I administer the enema.
    2. You must use the bathroom.
    3. You can put on an incontinence brief and have the bowel movement in the brief.
    4. It is easy to hold in the fluid and stool after administering the enema, so you don't have to worry about soiling yourself.
    1. Lubricant
    2. Enema administration set
    3. Absorbent pads
    4. Sterile gauze
    5. Tape

    Author of lecture Enema Administration: Pre-Procedure (Nursing)

     Samantha Rhea, MSN, RN

    Samantha Rhea, MSN, RN

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