enema/suppository

Question 1

hypotonic

Answer 1

tap water enema
large volume
rapid colonic emptying

Question 2

isotonic

Answer 2

normal saline solution
large volume enema
rapid colonic emptying

Question 3

hypertonic

Answer 3

draw water into colon stimulating defecation reflex

contraindicated in pts with sodium retention, renal impairment, or reduced renal clearance

Question 4

cleansing enema admin

Answer 4

solution (105-110F)
Verify order
bed pan read (defecation occurs within 5-15 minutes)
left side (Sims position)
elevate solution no higher than 18” above anus
give slowly over period of 5-10 minutes
lubricate rectal tube 2-3”
insert enema tube 3-4” pointing toward umbilicus
encourage pt to hold solution until urge to defecate is strong (5-15 min)

Question 5

rectal suppository

Answer 5

sims position
lubricate round end of suppository
insert using index finger 3-4"
remain on side for at least 5 minutes
melts at body temp

Question 6

digital removal of stool

Answer 6

side lying position

may stimulate vagus nerve, resulting in bradycardia (stop procedure, monitor HR and BP and notify MD)

Question 7

cleansing enemas

Answer 7

tap water
normal saline solution
soap solution
hypertonic solution