Nursing Practical Guideline Procedure : Enema

Enema:

An enema is an infection of fluid into the rectum and this may be ordered for various reasons :

1.     To empty to bowel of faces

2.     To relieve distension due to flack us

3.     To introduce fluids or drugs into to body

4.     For diagnostic purposes

5.     Before operation and before delivery

6.     Cleansing enema or simple enema

Requirements:

1.     Soap solution 25 ml

2.     Warm water 500 ml

3.     Lotion thermometer

4.     2-3 feet  long rubber tube with enema can

5.     Stop cock

6.     Glass connection

7.     Saline stand

8.     Kidney tray

9.     Rubber catheter 8' to 10'

10.            Lubricont (Vascline)

11.            Cotton swabs

12.            bedpen with lid

Procedure :

1.     Prepare the enama solution (soap solution 25 ml with 500 ml warm water) mix it well with a rod

2.     Examine the enema con whether it works properly.

3.     Explain the patient, Bring all the articles near to the bed side.

4.     Screen bring the patients buttocks to the edge of the bed.

5.     Keep the necessary portion open place the rubber sheet and towel under the buttocks. Keep the kidney tray also.

6.     Lubricate the catheter with Vaseline.

7.     Lift the enema on and fill the solution and let the air come out from the rubber tube.

8.     Ask the patient to the easy and take deep breath by mouth

9.     Insert the rubber catheter 7-10 cm into the rectum open the stop - cock.

10.                        Let the soap and water flow slowly into the rectum. The enema can be longed above 50 cm from the bed. If the patient complaints of severe pain stop the stop-cock. After some time again open the stop-cock Let it flow slowly before the soap solution gets over stop the stop cock so that the air should not enter into the rectum.

11.                        Remove the rubber catheter and put it into the kidney tray.

12.                        Hold the buttocks for some time so that the water should be retained in the rectum atleast for 5 to 10 minutes.

13.                        Make the patient sit or the bed pan so that we can find out the result make to patient go to the toilet.

a.     If the patient is able to cater to his or her needs by himself let him do it otherwise the nurse has to check the rectum with the cotton swabs.

14.                        After half an hour the enema result should be good. Only the water you gave come out means you have to inform the senior nurse.

15.                        Remove the rubber sheet and towel. Make the patient lie comfortably .

16.                        Make a nite of the contest inside the bed pan

17.                        Remove all the equipments rubber catheter should be washed old disinfected keep all thins in respective places.

18.                        Wash your hands well. Record the type of enema timings and the result.

Barium enema :

Purposes :

To diagnose if there is any ulcer tumor in the large intestines

1.     Before giving this barium enema the bowel should be emptied previous night itself some locative or enema should be given by the instruction of medical officer.

2.     Take the patient to the X-ray room, make the patient lie down left lateral position insert the rubber catheter into the rectum slowly to barium should be given. While giving the x-ray will be taken.

3.     After some hours also patient will be asked to remain there for some more X-ray pictures to be taken.

4.     Generally after taking all X-rays patient should be given some food.

Reasons for giving intra muscular injections

1.     Immediate effect

2.     Patient is vomiting continuously

3.     When the patient is unconscious or be cannot swallow the medicine.

4.     Immediate effect when you inject at the some place.

Precautions :

1.     Only what it is necessary the injections should be given

2.     Medicines manufacturing date as well as expiry date The action of the drug is quicker. Then when given by mouth. So you should be careful before giving injections

3.     Use the sharp needles

4.     Select the correct medicines. Don' t push the entire length of the needles. It may break.

5.     When you give injection for unconscious patients and also for the children you need assistant.

6.     The syringes and needles should be sterlised properly the patient wall get abscess.

7.     The injections should be given in correct places. The correct technique of giving injections should be used.

8.     Always you must keep one inj of adernaline empode in the tray. If the patient gets any allergic shocks before giving any injections, the sensitivity rest to be given

Sires for giving injections :

1.     Gluteal muscles

2.     Deltoid muscles

3.     Quadriceps muscles