SKILL 13-3 Administering a Small-Volume Cleansing Enema Goal: The patient expels feces and reports a decrease in pain

and discomfort. 1. Verify the order for the enema. Identify the patient. Explain procedure to patient. Discuss where the patient will defecate. Have a bedpan, commode, or nearby bathroom ready for use. . !erform hand hy"iene. #. !ull the curtains around the bed and close the room door. If bed is ad$ustable, place it in hi"h position. %. !osition the patient on the left side &'ims( position), as dictated by patient comfort and condition. *old top linen bac+ $ust enou"h to allow access to the patient(s rectal area. !lace a waterproof pad under the patient(s hip. ,. !ut on nonsterile "loves. -. .emove the cap and "enerously lubricate end of rectal tube / to #/ &,01 cm). 1. 2ift buttoc+ to expose anus. 'lowly and "ently insert the rectal tube #/ to %/ &1013 cm) for an adult. Direct it at an an"le pointin" toward the umbilicus, not bladder. 4s+ patient to ta+e several deep breaths. 5. Do not force entry of the tube. 4s+ patient to ta+e several deep breaths. 6. 7ompress the container with your hands. .oll the end up on itself, toward the rectal tip. 4dminister all the solution in the container. 13. 4fter solution has been "iven, remove tube, +eepin" the container compressed. Have paper towel ready to receive tube as it is withdrawn. Encoura"e the patient to hold the solution until the ur"e to defecate is stron", usually in about , to 1, minutes.

11. .emove "loves. .eturn the patient to a comfortable position. 8a+e sure the linens under the patient are dry. Ensure that the patient is covered. 1 . .aise side rail. 2ower bed hei"ht and ad$ust head of bed to a comfortable position. 1#. .emove any remainin" e9uipment. !erform hand hy"iene. 1%. :hen patient has a stron" ur"e to defecate, place him or her in a sittin" position on a bedpan or assist to commode or bathroom. 'tay with patient or have call li"ht readily accessible. 1,. .emind patient not to flush commode before nurse inspects results of enema. 1-. !ut on "loves and assist patient if necessary with cleanin" of anal area. ;ffer washcloths, soap, and water for handwashin". .emove "loves. 11. 2eave the patient clean and comfortable. 7are for e9uipment properly. 15. !erform hand hy"iene.