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Dr. Albert Fish Presents:
How to Administer an Enema
This comprehensive DVD will provide you
with instruction on the proper administration of an enema.
Only $19.95
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Before
administering an enema, ensure the patient's privacy by closing the room door.
The patient should be encouraged to empty both bladder and bowels before the
procedure. Have the patient undress completely from the waist down. Position the
patient on the bed on his or her left side with the top knee bent and pulled
slightly upward toward the chin. Place a waterproof pad under the patient's hips
to protect the bedding and drape a sheet over the patient covering the entire
body except the buttocks. Place a bedpan and toilet paper within quick access.
Explain the procedure to the patient. Emphasize the importance of breathing
slowly through the mouth to encourage relaxation of the rectal sphincter and to
avoid oppositional pressure. Let the patient know that while he or she may feel
the urge to defecate, most enemas need time to work and he or she should try to
hold the fluid for at least five to 10 minutes after instillation (30 to 60 minutes
for retention enemas and longer for some medicated enema solutions). Check the
medication label if it is a medicated solution to avoid medication errors. Be
sure it is the right medicine, the right dose (strength), the right time, the
right person, and the right method. Verify the expiration date on the label. Do
not use outdated medicine.
Wash hands thoroughly and put on gloves. To prepare for premixed disposable
enema instillations, follow the directions on the package. Most premixed
disposable enemas come with the tip already lubricated. Shake the solution
bottle. Remove the cap from the tip and expel excess air from the apparatus
before use. To prepare solutions to be administered using an enema bag, heat the
solution to 105 degrees F. Adult solutions are generally 750 to 1000cc of solution for a
non-retention enema and 150 to 200cc of fluid for a retention enema. Children's
solutions are 250 to 500cc of solution for a non-retention enema and 75 to 150cc of
solution for a retention enema. Infants' solutions are 150 to 250cc of solution for
a non-retention enema. If preparing a medicated solution, follow the physician's
orders. Select a rectal tube appropriate
To administer an enema solution, the clinician should have the patient lie down
on the left side, knees bent. Lift the upper buttock so that the rectal opening
can be visualized. Place the lubricated tip of the enema catheter at the anal
opening, and gently advance the catheter through the anal sphincter into the
rectum toward the umbilicus (navel), 3 or 4 in (7.5 to 10 cm) for an adult. Insert the
tubing 2 in (5 cm) for a child less than six years and 1 in (2.5 cm) for an
infant. After alerting the patient, open the enema tubing to allow the solution
to flow or squeeze premixed enema solutions slowly into the rectum. If the
patient complains of cramping, slow or stop the enema flow and have the patient
breathe slowly through the mouth to encourage relaxation. When giving fluid
through an enema bag, start with the bag suspended from an IV pole at the
patient's hip level. As the tubing is opened, slowly raise the IV pole to
promote fluid flow until the bag is 12 inches (30.5 cm) above the hip for an
adult. Continue to hold the rectal tube in place throughout the procedure or it
will be expelled from the rectum. If the fluid will not flow in, gently rotate
the tubing within the rectum to clear the holes of the tubing from the wall of
the bowel or the impacted stool that may be occluding the flow. If ordered to
give a high enema, slowly raise the bag no more than 18 inches (46 cm) above the
adult patient's hip (12 inches (30.5 cm) above a child's hip and six inches (15
cm) above an infant's hip). This will increase the water pressure to deliver the
fluid higher into the bowel. When all of the solution has been administered,
clamp the tubing, remove the enema catheter, and release the buttock.
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