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Distension enema

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Distension Enema

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Procedure Steps of Procedure 1. Wash hands Reason: to prevent cross infection 2. Attach the tubing to the enema can and clamp the tube Reason: to prepare the solution and be ready for the administration 3.

Prepare the solution at the required temperature. Add 30 ml of soap jelly to ml of water. Test the temperature of the solution at the inner aspect of the wrist.

Remove the forth from the can. Reason: temperature above 43 degree celcius may injure tissues and temperature below 21 degree celcius may produce severe cramping.

Hang the can with the solution on the stand and adjust the height at 45 cm from the anus. Reason: the rate of flow and the pressure of the fluid will increase according to the height of the can.

Attach a rectal tube to the tubing. Loosen the screw clamp and let a small amount of fluid to run into the kidney tray.

Regulate the flow of the solution by adjusting the screw clamp. Pinch the tubing with fingers. Read the level of the fluid in the enema can. Reason: running the fluid through tube will help to expel the air from the tubing and make sure that the whole apparatus is in working order.

Reading the level of the fluid can help us to calculate the amount of fluid introduced into the rectum. Lubricate the tip of the rectal tube about 2 to 4 inches from the tip.

Lubricant is applied to the minimum with a rag piece. Reason: lubrication of the tube will prevent friction. The lubricant should not block the tube.

Reason: forceful insertion of the rectal tube may injure the anal or rectal tissue. Hold the enema tube in place while releasing the pressure on the tube and let the fluid run in.

Read the level of the fluid and make sure that is flowing. Reason: holding the tube throughout the procedure will prevent the displacement of the tube.

During the administration of the fluid ask the client to take panting breaths. Reason: breathing will open mouth relaxes the abdominal muscles, decreases pressure on the colon.

Also distract the client enough to relax abdominal muscles. Reason: temporary stoppage of the fluid will relax the bowels as the peristaltic movement is passed off.

Continue the fluid administration to give about to ml of solution. Stop the procedure if the client develops discomfort.

Reason: large amount of faeces in the colon decreases the volume of the solution retained comfortably. Clamp the tubing.

Gently remove the rectal tube by pulling it through 3 to 4 layers of rag pieces. Hold the rag pieces around the tube and firmly against the anus.

Reason: holding the rag pieces around the tube cleanses the tube by removing the faeces from the tube. The pressure applied on the anus will help the client to maintain the control of the anal sphincter.

Discard the rag pieces in the paper bag. Detach the rectal tube and place it in the kidney tray. Reason: avoid contamination of the articles and environment, with the soiled articles.

After Care of the Patient and Articles 1. Encourage the clients to retain the fluid for 10 to 15 minutes. Encourage slow breathing with open mouth for relaxation.

Turn the client on the back and assist him onto toilet, commode or bedpan. Give a call signal to the client and leave him alone for sometime if safe.

Observe enema results, noting the color, consistency and the amount. Obtain specimens if desired. Bring the toilet tray and assist him for perineal care.

If bedpan is used, the second bedpan is placed under the buttocks before the perineal care. Remove the bedpan, dry the client, put on the garments, change the bed linen if needed, straighten the sheets and adjust the position of the client in the bed to make him comfortable.

Explain the client that he may need to evacuate the bowels several times in the next few hours. Take the bedpan to the sanitary annex, inspect the contents, empty the bedpan, clean it and keep it on the bedpan rack ready for the next use.

Take all articles to the utility room. Disinfect the rectal tube, clean it and boil it and store it in its proper place in the proper manner.

Wash hands. Return to the bedside. Take vital signs if the client is pale and sweating. Report immediately and get medical aid for the client.

Send the specimens if any, to the laboratory. Giving Enema with Funnel and Catheter e. Oil Enema Small enemas to be expelled are given using funnel and catheter.

The oil is kept warm by placing the container in a bowl of warm water. During the administration, the height of the funnel should not be more than 8 inches from the anus.

Help the client to retain the solution either by raising the foot end or by pressing buttocks. The oil enema is to be retained for 2 to 6 hours to soften the faecal matter.

It may be then followed by a soap and water enema to expel the faecal contents. The preparation and after care of the client and articles are same as in soap and water enema.

Giving Enema using a Glycerin Syringe e. Air is to be expelled from the syringe and the tube, prior to the administration of the fluids.

This method is particularly useful for giving enema to children. Giving Enema by the Drip Method e. The main purpose of the procedure is that the solution is to be retained and should never be evacuated.

A fine catheter is used in the place of a rectal tube to diminish the stimulation of the defecation reflex. The reservoir is raised above the anus only far enough to allow the solution to run slowly into the rectum or the flow is regulated by a Murphy drip and a clamp to less than 40 drops per minute because administration of a large amount of fluid at a time will distend the rectum, causing defecation.

The foot end is raised to retain the fluid. Usually a retention enema is preceded by a simple enema to keep the bowels free of faecal matter to aid absorption of fluids and drugs.

There are several varieties of suppositories available e. Some act as a local irritant which stimulates secretion by the mucosa, while others act directly on the nerve endings and stimulate peristalsis.

The suppositories are to be kept in the refrigerator, because they melt at room temperature and insertion becomes difficult.

Before introducing suppositories, explain the procedure to the client. The client is placed in a comfortable position, usually left lateral.

Suppository is removed from its package and held in the right hand between the two fingers the nurse wears a glove on a finger cot. Separating the buttocks with the left hand insert the suppository into the anus.

Once it has passed the external sphincter, advance it beyond the internal sphincter, pushing it with the index finger, otherwise the suppository will be expelled from the anal canal.

The nurse should make sure that the suppository is positioned to the side of the rectum against the mucosa, rather than in the faecal matter, because the intended action of the medication is on the intestinal wall.

The client should be instructed to retain the suppository as long as it is comfortable — about 20 to 30 minutes or even longer. Prepare the client as for an enema.

Place the client in a comfortable position. Lubricate the flatus tube and introduce 4 to 6 inches into the anus canal while the free end of the tube being kept under the water in the kidney tray.

Watch for the expulsion of the gas which is seen bubbling through the water. The tube is left in place for not more than 20 minutes; longer periods of insertion can lead to permanent sphincter damage.

The tube can be re-inserted every 3 to 4 hours, if necessary. Evacuant Enema. Retained Enema Evacuant Enema is classified into 1. Simple evacuant enema.

Cold enema. Medicated evacuant enema. Medicated evacuant enema is classified into 1. Oil enema. Purgative enema. Astringent enema.

Anthelmintic enema. Carminative enema. General Instructions for Giving Enema 1. The appropriate size catheter or rectal tube need to be used.

For giving a cleansing enema use no. The rectal tube needs to be smooth and flexible. Any tube with a sharp or ragged edge should not be used because of the possibility of damaging the mucus membrane of the rectum.

The rectum tube is lubricated with a water soluble lubricant or with Vaseline to facilitate insertion and to decrease irritation of the rectal mucosa.

Use only a small amount to prevent blockage of the tube. The temperature of the solutions needs to be adjusted according to the purpose of the enema.

To give an evacuant enema, the temperature should be between A retained enema should be given at the body temperature. The amount of the solution to be administered depends upon the type of the enema and the age and size of the person.

For giving evacuant enema use to ml for adults, to ml for a child and ml or less for an infant. For giving retained enema, the quantity given at a time should not be more than ml to ml so that the rectum will not be distended to cause peristaltic movement.

When an enema is administered, the client usually assumes a left lateral position. In this position, the position of the sigmoid colon is below the rectum, thus facilitating instillation of the fluid.

For a high cleansing enema, the client changes position during the administration of the enema from left lateral to dorsal recumbent and then to right lateral.

In this way the entire colon will be reached by fluid. For an evacuant enema the bed should be made flat and for a retained enema the foot end should be raised.

The distance to which the tube is inserted depends upon the age and the size of the client. For an adult it is normally inserted 7.

If any obstruction is encountered, it should be withdrawn and reported. The height of the can should be adjusted to regulate the flow of the solution according to the type of the enema administered.

For cleansing enemas, the height of the can should not be above 18 inches 45 cm from the anus and for retention enemas, it should not be above 8 inches 20 cm from the anus.

Faites un lavement de Lugol-curcuma une fois par jour. The enema was kept whenever possible longer. The object of this invention is to provide an enema preparation effective in treating inflammatory bowel diseases.

This solution can be dispensed via an enema tube or other delivery apparatus for infusion into a patient's gastrointestinal tract. Identification of alternatives: atropine, lidocaine given diluted intrarectally as an enema.

The long attachment plug has an enema head with several multi-directional jets, for optimal cleaning. This intimate enema system holds up to ml of liquid and has a multi-jet cleaning nozzle.

I've never done one of those enema things before. Je n'ai jamais fait de lavement avant. Barium enema also can exclude other intestinal problems that mimic appendicitis, for example Crohn's disease.

Kasayavasthi is a type of medicated enema. Kasayavasthi est une sorte de lavement traitant. But it would show up on a barium enema.

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