Nursing notes chapter 11 PDF

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chapter 11 notes...

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Definition An enema is an introduction of fluid into the lower bowel through the rectum for the purpose of cleansing or to introduce medication or nourishment.

Purpose               

To stimulate defecation & to treat constipation ex: simple evacuant enema To soften hard faecal matter ex: oil enema To administer medication ex: sedative enema To protect and soothe the mucus membrane of intestine & to check diarrhoea ex : emollient enema To destroy intestinal parasites ex : anthelminitic enema To relieve the gaseous distention ex : carminitive enema To administer the fluid and nutrients ex: nutritive enema To relieve inflammation ex : astringent enema To induce peristalsis ex : purgative enema To stimulate a person in shock and collapse ex: stimulant enema To reduce the temperature ex : cold enema or ice enema To clean the bowels prior to x-ray studies , visualization of the bowel , surgery on the bowel or delivery of a baby ex : saline enema To make diagnosis ex: barium enema To establish regular bowel functions during a bowel training programme To induce anesthesia ex : anesthetic enema

Cleansing Enemas Stimulate peristalsis through irrigation of colon and rectum and by distention 1. Soap Suds: Mild soap solutions stimulate and irritate intestinal mucosa. Dilute 5 ml of castile soap in 1000 ml of water 2. Tap water: Give caution o infants or to adults with altered cardiac and renal reserve 3. Saline: For normal saline enemas, use smaller volume of solution

4.

Prepackaged disposable enema (Fleet): Approximately 125 cc, tip is pre-lubricate and does not require further preparation

Oil-Retention Enemas 

Lubricates the rectum and colon; the feces absorb the oil and become softer and easier to pass

Carminative Enema 

Provides relief from gaseous distention

Astringent Enema 

Contracts tissue to control bleeding

Key Points: Administering Enema 1.

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Fill water container with 750 to 1000 cc of lukewarm solution, (500 cc or less for children, 250 cc or less fro an infant), 99 degrees F to 102 degrees F. Solutions that are too hot or too cold, or solutions that are instilled too quickly, can cause cramping and damage to rectal tissues Allow solution to run through the tubing so that air is removed Place client on left side in Sim’s position Lubricate the tip of the tubing with water-soluble lubricant Gently insert tubing into client’s rectum (3 to 4 inches for adult, 1 inch for infants, 2 to 3 inches for children), past the external and internal sphincters Raise the water container no more than 12 to 18 inches above the client Allow solution to flow slowly. If the flow is slow, the client will experience fewer cramps. The client will also be able to tolerate and retain a greater volume of solution After you have instilled the solution, instruct client to hold solution for about 10 to 15 minutes Oil retention: enemas should be retained at least 1 hour. Cleansing enemas are retained 10 to 15 minutes....