Enema

Question 1

3 types of enemas

Answer 1

cleansing, retention and return flow (Harris flush)

Question 2

after solution is introduced, patient should be instructed to:

Answer 2

hold solution until urge to defecate is strong - usually 5-15 min

Question 3

Can an AP administer an enema?

Answer 3

non

Question 4

Describe large volume enema and why used

Answer 4

The purpose of large volume enema is to clean as much of the colon as possible of feces, as an intervention for constipation as well as “bowel prep” before a diagnostic procedure. The amount used is 500-1000 ml and the bag is raised as high as 18 inches above.the anal opening. The patient is instructed to retain and hold the fluid as long as possible to induce peristalsis and cause evacuation of feces. Patient turns to right side to allow fluid to follow shape of intestines

Question 5

Describe return flow (Harris Flush) enema and why used.

Answer 5

A return-flow enema, or Harris flush, is used to remove intestinal gas and stimulate peristalsis. A large volume fluid is used but the fluid is instilled in 100-200 ml increments. Then, the fluid is drawn out by lowering the container below the level of the bowel. This brings the flatus out with the fluid. Repeat this procedure three to five times or until no gas is returned.

Question 6

Describe small volume enema and why used

Answer 6

The small volume enema is used to clean the lower portion of the colon or the sigmoid. This type of cleansing enema is often used for the patient who is constipated but does not need cleansing of the higher colon. The amount used is less than 500 ml and the bag is raised no higher than 12 inches.

Question 7

Factors that affect response to enemas

Answer 7

height of container
sped of flow
concentration of solution
Rectum resistance - muscle tone, client hx

Question 8

Fleet enema

Answer 8

look this up

Question 9

Hold container no higher than

Answer 9

12 - 18 inches about anus

Question 10

how do hypertonic solutions work in the body?

Answer 10

draw fluid from the body to lubricate the stool and distend the rectum. Hypertonic solutions are contraindicated in dehydrated clients and small children.

Question 11

how is patient positioned

Answer 11

left side with fight leg flexed forward

Question 12

How many inches to insert into rectum

Answer 12

3-4 for adults

Question 13

How many inches to lubricate tip

Answer 13

2-3

Question 14

If client is using toilet - remind them

Answer 14

to not flush until you have inspected

Question 15

Introduce solution over how many min

Answer 15

slowly - 5-10 min

Question 16

Safest enema solution

Answer 16

normal saline

Question 17

Temperature of solution

Answer 17

Room temp or slightly warmer - test on writst

Question 18

What is the first thing you need to administer and enema?

Answer 18

order!

Question 19

What kind of enema solution is normal saline - how does it react?

Answer 19

isotonic solution. It is the same concentration as the body’s own fluids and is considered to be a safe enema solution. It is important that children and infants only be given normal saline enemas since their small size predisposes them to fluid imbalances.

Question 20

What kind of enema solution is tapwater - why?

Answer 20

hypotonic solution. Because it is a less concentrated solution than the body’s cells, it is drawn into the body and may cause water toxicity, electrolyte imbalance, or circulatory overload.