Download Learning Objectives What is an Enema or a Suppository?

25-08-2015
Training for Healthcare Professionals
Medicine
Administration
Module : Specimen
Collection
– Blood Culture
Enema & Suppository
© 2013, Wadhwani Foundation. All Rights reserved.
Learning Objectives
After completing this module you will be able to:
• Describe what is an enema and a suppository
• Prepare an enema and a suppository
• Demonstrate the correct technique to administer an
enema/suppository
Copyright © 2013 Wadhwani Foundation| All rights reserved.
What is an Enema or a Suppository?
Enema – An enema is insertion of fluid/
medication for producing a bowel motion
Suppositories – A suppository is primarily a
medicine given through the rectum.
ENEMA
Click the images to know what are enemas and suppositories.
They should not be administered when the patient
has had:
 Recent colorectal or gynecological surgery
 Cancer of the perineal area or hemorrhoids
(piles)
 Profuse rectal bleeding
 Renal insufficiency
 Heart failure
SUPPOSITORY
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25-08-2015
When and Why are Enemas or Suppositories
Recommended?
• To empty the lower bowel before a
surgical procedure, delivery or
endoscopic examination
Before surgery
• To give medication when oral or other
route medications can’t be given
No Oral Medication
Piles
• As treatment for hemorrhoids or piles
• As treatment for constipation
Constipation
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On Whom
They are given to patients who have the following
symptoms:
•
•
•
•
•
•
•
•
Abdominal distension and discomfort
Halitosis (bad breath) due to stomach infections
Loss of appetite
Nausea and vomiting
Diarrhea
Hard, dry stool or soft stool difficult to pass
Urinary retention and/or urinary incontinence
Constipation
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Items Needed
1. Single use non sterile
disposable gloves
2. Single use disposable
apron
3. Disposable under pad to
protect the bed
4. Lubrication Gel
5. Tissues/wipes
6. Access to
toilet/commode/bedpan
7. Prescribed
Suppository/Enema
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25-08-2015
How is The Procedure Done
1 - Preparation
1. Check the 7 rights of medication
2. Explain procedure and obtain valid and
informed consent
3. Check for allergies
4. Check enema/suppository against medicine
chart
5. Close curtain for privacy
6. Give the patient an opportunity to urinate
7. Ensure a bedpan, commode or toilet is
readily available
8. Wash hands and wear gloves
9. Wear the disposable apron
Click the link to view the 7 Rights of Medication.
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How is The Procedure Done
2 – Administration
1. Position the patient on their left lateral side as this facilitates easy
flow of fluid
2. Flex upper limb and keep lower limb straight
3. Ask the patient to bend their knees, or assist patient into position
4. Place absorbent pad under patient
5. Examine the perineal area for any abnormalities
ENEMA
SUPPOSITORY
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How is The Procedure Done
2 – Administration
ENEMA
SUPPOSITORY
• Push out any air from the enema
and lubricate the tip with gel
• Insert the nozzle into the anal
canal to approximately 4 inches,
aiming towards the left hip
• Squeeze the tube from the
bottom, ensuring all the fluid
enters the patient.
• Ask patient to breathe normally
• Slowly withdraw the nozzle to
prevent leakage
• Lubricate the open end of the
suppository and your index
finger
• Insert the suppository, open
end first into the rectum
• Gently remove finger
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25-08-2015
How is The Procedure Done
3 - Post procedure
1. Ensure the patient is comfortable
and ask him/her to try and retain
the enema for 10-15 minutes or
over 30 minutes for suppositories
2.
Assist patient with toilet if
required
3. Document the effect of the
laxative
4. Leave patient comfortable
5. Immediately inform the doctor in
case of any abnormalities
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Activity – Administering Enema/ Suppository
Time Required (suggested) : 20 Minutes
Items Needed: Dummy, gloves, apron, under pad, lubrication gel, wipes,
commode/bedpan, prescribed suppository/enema
Form Groups
Divide
yourselves into
groups based
on the number
of item sets
available
• Select
Leader to
direct activity
Initial Demo
Each group selects
one volunteer to be
a “nurse” and
dummy to be
“patient”
• Nurse
administers
enema/Supposit
ory
Feedback
Rest of the
group
gives
feedback
to Nurse
on what
he/she did
right or
wrong
Repeat Demo
A second set
of volunteers
are selected.
• Nurse
administers
enema/sup
pository
Class Demo
If time
permits, one
set of
volunteers
(Nurse and
Patient) does
the demo in
front of entire
class
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Points to Remember!
 Do not give an enema within an hour following a meal
 If possible give before bath
 Insert tube 2-4 inches into the rectum
 Administer slowly over 10-15 min
 Always document results/abnormalities
 Maintain patient dignity and privacy
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25-08-2015
Check Your Learning – 1
Select whether true or false:
It is always advisable to give enema after bath.
1. True
2. False
ENEMA
Select one option and click Submit.
Copyright © 2013 Wadhwani Foundation| All rights reserved.
Check Your Learning – 2
When is enema generally given?
Piles
Before surgery
No Oral Medication
Constipation
Select the correct options and click Submit.
Copyright © 2013 Wadhwani Foundation| All rights reserved.
Check Your Learning – 3
Arrange the following in the right order.
1. Ensure patient is comfortable and ask them to try and retain the
enema for 10-15 minutes or over 30 minutes for suppositories
2. Ensure a bedpan, commode or toilet is readily available
3. Ask the patient to bend their knees, or assist patient into position
4. Administer enema/suppository
5. Check enema/suppository against medicine chart
6. Assist with toileting if needed
7. Position the patient on their left side as this facilitates easy flow of
fluid
Copyright © 2013 Wadhwani Foundation| All rights reserved.
5
25-08-2015
Check Your Learning – 4
Enema/suppository should not be administered to,
1.
2.
3.
4.
Patient had recent gynecological surgery
Profuse rectal bleeding
Renal insufficiency
Heart failure
Select all the correct options and click.
Copyright © 2013 Wadhwani Foundation| All rights reserved.
Check Your Learning – 5
Enemas or suppositories are given to the patients with,
1.
2.
3.
4.
Abdominal distension and discomfort
Halitosis or bad breath due to stomach infections
Loss of appetite
Constipation
Select all the correct options and click.
Copyright © 2013 Wadhwani Foundation| All rights reserved.
Resources
 We would sincerely like to thank the following entities for the
resources and references:
• Ashley Goodoien
 For further reference please refer to:
• http://www.wikihow.com/Give-an-Enema
• http://www.nursingtimes.net/nursing-practice/clinicalzones/gastroenterology/how-to-administer-anenema/203226.article
• http://www.consumermedsafety.org/component/k2/item/462administration-of-rectal-suppositories-or-enemas
Copyright © 2013 Wadhwani Foundation| All rights reserved.
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