Checklist for Skill 28.

Administration of Enemas
Name _________________________________________________________________ Date ____________________________ School ________________________________________________________________ Instructor ______________________________________________________________ Course ________________________________________________________________

Skill 28. Administration of Enemas

Safety
1. 2. 3. 4. Never force catheter into anal canal. If a well lubricated catheter does not advance easily, stop enema. Use only isotonic solutions. Give only the prescribed amount of solution. The smaller the child the less the amount of fluid that can be safely given. Give only the number of enemas prescribed.

Able to Perform

Able to Perform with Assistance

Unable to Perform

Initials and Date

Procedure
1. Check physicians order. Comments: Gather equipment. Comments: Wash hands. Comments: Explain procedure to child and family. Comments: Fill container with prescribed enema solution, unless it is a prepackaged enema. Comments: Warm solution to body temperature or 37.7 C, 100 F. Comments: Provide for childs privacy. Comments: Position waterproof pad under child. Comments: Position child. a. Left side, lateral recumbent position with knees up to chest. b. On back with legs lifted to expose anal orifice. c. Left side with right leg thigh flexed about 45 to body axis (Sims
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning, Inc. Permission to reproduce for clinical use granted.

Skill 28. Administration of Enemas

position). Comments: 10. Put on nonsterile gloves. Comments: 11. Lubricate rectal catheter/enema tip. Comments: 12. Prime rectal tube or nozzle of prepackaged enema. Comments: 13. Have child take a deep breath. Introduce catheter past anal sphincter into anal canal and lower rectum. Comments: 14. Once tip of catheter is in place, elevate bag and instill fluid slowly or squeeze prepackage enema. Do not elevate container more than 10 cm above rectum. Comments: 15. If child shows signs of distress, e.g., abdominal pain, shortness of breath, or chest pain, flow should be stopped. Comments: 16. When solution is completely administered or child cannot hold any more, clamp tube and remove. Comments: 17. Clean lubricant and any feces from anus with toilet paper. Comments: 18. Have child try to retain enema for the prescribed amount of time. May hold buttocks together. Comments: 19. After prescribed amount of time, place child on bed pan, potty chair, toilet, or apply clean diaper. Comments: 20. After child expels the enema, cleanse the anal area as needed. Comments: 21. Dispose of equipment in appropriate container. Comments:

Able to Perform

Able to Perform with Assistance

Unable to Perform

Initials and Date

Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning, Inc. Permission to reproduce for clinical use granted.

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Skill 28. Administration of Enemas

22. Remove gloves. Wash hands. Comments:

Able to Perform

Able to Perform with Assistance

Unable to Perform

Initials and Date

Documentation
1. 2. Procedure, including specific type of enema, and how child tolerated it. Results of enema. Comments:

Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning, Inc. Permission to reproduce for clinical use granted.

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