Lab: Bowel Elimination Flashcards
Bedside Commode
If the client is able to get out of bed but cannot walk to the bathroom. Place a bedside commode at the bedside for easy accessibility.
Bedpans: Regular & Fracture
Regular:
- hard plastic, curved smooth upper end and a tapered lower end
- Clients who are able to lift their hips and have no mobility restrictions of the lower extremities
Fracture Bedpan
- hard plastic, flat upper end that makes sliding the bedpan under the client easier
- Clients who are in body or leg casts, have a lower extremity fracture, or are ubable to raise their hips
Cleansing Enema
Solutions:
- 0.9% sodium chloride (isotonic): doesn’t pull electrolytes or shift fluids in/out of the colon
- Sodium phosphate (hypotonic): Exerts osmotic pressure causing water to move from the colon to the interstitial space. Should not be repeated for fear of water toxicity or circulatory overload
- Soapsuds: stimulate peristalsis through intestinal irritaiton. 5mL of castile soap to 1L solution, Can cause bowel inflammation.
- Have bedpan or commode easily excessable
- cover bedside table from contaminants
- don PPE as required
- Prepare supplies near bedside
- ensure clamp on the tubing is closed
- pour solution into the container
- open the clamp and prime the tubing
- right arm up over your head, and left arm behind your pack
- seperate buttock to check for any abnormalities
- lubricate 2-3 inches of the rectal tube with water soluble lubricant
- take a couple of deep breaths and slowly breath out through the mouth
- gently insert the tip 3-4in into the rectum, pointing the tip towards the umbilicus
- container 12-18 inches above the rectum and holding the tubing in place
- slowly release the clamp
- if patient feels uncomfortable, slow by lowering the container or clamp for 30 seconds
- hold for as long as you can and roll onto your back (5-10mins)
- dispose equipment, lower bed, call light, document
Retention Enema
- Accessible commode
- turn patient to their left side, right arm up, left arm behind their back
- spread buttock and check for abnormalities
- lubricate tip
- take a deep breath, slowly breath out, insert tip 3-4 in while they’re breathing out
- keep container squeezed when pulling out to keep the fluid from coming back out
- patient on their back,
Return Flow Enema
- have bedpan or commode easily accessible
- PPE
- attach tubing to container, make sure clamp is closed
- pour solution into the container, open clamp and prime tubing
- have patient turn to their left side, right leg over the left leg, right arm up over their head, left arm behind their back
- inspect anal opening for abnormalities such as fissure and hemmoroids
- lubricate tip
- deep breath, slowly breath out, as they breath out insert the tip towards the umbilical
- if patient feel uncomfortable, lower the container or close the clamp for 30 secs then restart flow
- lower the container to allow the liquid to flow back into the container
- raise the container to let the liquid flow back into the rectum
- repeat the process 5-6 times or as prescribed
- replace the solution if it becomes thick with feces
- clamp the tubing and remove it from the rectum
- remove PPE, hand hygiene, place linens back over the patient, move them onto their back, hand hygiene
Enema: Involves, Use, Solution Types, Patient Position
- Involves instilling a solution into the rectum and sigmoid colon to stimulate peristalsis and promote defecation
- used to relieve constipation, expel flatus, empty bowels before a diagnostic procedure/surgery, instill medication, initiate a bowel training program
Solutions:
- tap water (hypotonic)
- normal saline
- soap suds
- hypertonic
- carminative
- medicated
- oil
Patient Position:
- left side lying position/left lateral position
- right knee flexed over the left leg
- right arm over their head
- left arm behind their back
Oil Retention Enema
- Used to lubricate the rectum and the colon, administered at room temp
- the oil is absorbed by the feces, making them softer and easier to pass
Volume Guideline for Large Volume Enema
Infant: 150-250mL
Toddler: 250-350mL
Child: 300-500mL
Adolescent: 500-750mL
Adult: 750-1,000mL
