Bowel Elimination

Question 1

What is a cleansing enema?

Answer 1

Most common/traditional type of enema. Used for general constipation. Solutions used are tap water, normal saline, and a soap suds solution.

Question 2

What is an oil enema?

Answer 2

Slowly softens hard stool and eventually relieves constipation

Question 3

What is a carminative/return flow “flush” enema?

Answer 3

Quickly relieves gaseous distension and stimulates bowel function.

Question 4

What is a bedside commod?

Answer 4

A portable toilet chair you can keep next to a patient’s bed.

Question 5

What are the two types of bedpans?

Answer 5

Regular and fracture. A regular bedpans is used when the patient can raise their hips. A fracture bedpan is used when the patient cannot raise their hips.

Question 6

How do you place a bedpan on a non-ambulatory patient?

Answer 6

You assist the patient to their side and place the bedpan so that the taller side of the bedpan is under the buttocks and shorter side is between thighs. Return patient to their backs so that the bedpan is beneath their buttocks/thighs. Make sure the patient is sitting up.

Question 7

What PPE do you need when giving an enema?

Answer 7

Gown and gloves

Question 8

Why would you use an enema?

Answer 8

Stimulate peristalsis/promote defecation, relieve constipation, expel flatus, empty bowels before diag procedure/surgery, instill medication, initiate bowel movement.

Question 9

What solutions are commonly included in an enema?

Answer 9

Hypotonic tap water, normal saline, soap suds, hypertonic, carminative, medicated, or oil.

Question 10

What position should a patient be in to receive an enema.

Answer 10

Left-side lying (left lateral) position with the right knee flexed. Allows the solution to flow down the curve of the sigmoid colon and rectum.

Question 11

What is the length of the tube for an adult/adolescent?

Answer 11

3-4 inches

Question 12

What is the length of the tube for a child?

Answer 12

2-3 inches

Question 13

What is the length of the tube for an infant?

Answer 13

1-1.5 inches

Question 14

If the patient feels pain at the beginning of the insertion what should you do?

Answer 14

Ask the patient to take a deep breath to relax their spincter. Put a small amount of the tube in.

Question 15

How many enemas can you administer at once?

Answer 15

3

Question 16

Infants and children can only receive what type of enema?

Answer 16

Normal saline enemas. This will reduce their risk of an electrolyte imbalance.

Question 17

What are concerns regarding hypotonic and hypertonic enemas?

Answer 17

Hypotonic (tap water) will exert osmotic pressure so that water moves into the interstitial space. This can easily lead to toxicity or circ overload.

Hypertonic (sodium phosphate) draws water from the interstitial space into the colon. This dehydrates patients and can be fatal for infants/children.

Question 18

What enema do you use to cause bowel inflammation so that peristalsis can start?

Answer 18

Castile soap sud water. Do not use on pregnant people, old people, or children/infants.

Question 19

Oil enemas are usually over the counter and…

Answer 19

use a pre-filled plastic container with a rectal tip attached. Instruct the patient to ‘hold onto’ the enema for as long as possible, at least 30 minutes to be most effective. Administer at room temperature.

Question 20

What volume of solution should you use for a infant that is getting a return flush/flow enema?

Answer 20

150-250ml

Question 21

What volume of solution should you use for a toddler that is getting a return flush/flow enema?

Answer 21

250-350ml

Question 22

What volume of solution should you use for a child that is getting a return flush/flow enema?

Answer 22

300-500ml

Question 23

What volume of solution should you use for a adolescent that is getting a return flush/flow enema?

Answer 23

500-750ml

Question 24

What volume of solution should you use for a adult that is getting a return flush/flow enema?

Answer 24

750-1000ml

Question 25

How do you perform a return flow/flush enema?

Answer 25

Instill a large volume in small increments into rectum/sigmoid colon to stimulate peristalsis. Lower the container to allow the solution back into the container. Go back and forth to increase peristalsis and reduce flatus.

Question 26

What is a medicated enema?

Answer 26

An enema containing medication such as antibiotics and sodium polystyrene sulfonate. Use antibiotic to reduce bacteria before a surgery. You can use SPS to treat dangerously high serum potassium levels.

Question 27

What alternative type of enema can you use as a last resort?

Answer 27

Milk and molasses.