Bowel Elimination Flashcards
What is a cleansing enema?
Most common/traditional type of enema. Used for general constipation. Solutions used are tap water, normal saline, and a soap suds solution.
What is an oil enema?
Slowly softens hard stool and eventually relieves constipation
What is a carminative/return flow “flush” enema?
Quickly relieves gaseous distension and stimulates bowel function.
What is a bedside commod?
A portable toilet chair you can keep next to a patient’s bed.
What are the two types of bedpans?
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.
How do you place a bedpan on a non-ambulatory patient?
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.
What PPE do you need when giving an enema?
Gown and gloves
Why would you use an enema?
Stimulate peristalsis/promote defecation, relieve constipation, expel flatus, empty bowels before diag procedure/surgery, instill medication, initiate bowel movement.
What solutions are commonly included in an enema?
Hypotonic tap water, normal saline, soap suds, hypertonic, carminative, medicated, or oil.
What position should a patient be in to receive an enema.
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.
What is the length of the tube for an adult/adolescent?
3-4 inches
What is the length of the tube for a child?
2-3 inches
What is the length of the tube for an infant?
1-1.5 inches
If the patient feels pain at the beginning of the insertion what should you do?
Ask the patient to take a deep breath to relax their spincter. Put a small amount of the tube in.
How many enemas can you administer at once?
3
Infants and children can only receive what type of enema?
Normal saline enemas. This will reduce their risk of an electrolyte imbalance.
What are concerns regarding hypotonic and hypertonic enemas?
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.
What enema do you use to cause bowel inflammation so that peristalsis can start?
Castile soap sud water. Do not use on pregnant people, old people, or children/infants.
Oil enemas are usually over the counter and…
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.
What volume of solution should you use for a infant that is getting a return flush/flow enema?
150-250ml
What volume of solution should you use for a toddler that is getting a return flush/flow enema?
250-350ml
What volume of solution should you use for a child that is getting a return flush/flow enema?
300-500ml
What volume of solution should you use for a adolescent that is getting a return flush/flow enema?
500-750ml
What volume of solution should you use for a adult that is getting a return flush/flow enema?
750-1000ml
