The Procedural Work For an Enema

• Enema device
• Enema solution as per doctor's instructions, at an appropriate temperature (43°C for adults)
• Latex gloves – Personal protective equipment
• Medical gel to facilitate catheter insertion
• Solution holder – Blanket
• Protective plastic sheet
• Dressing and gauze

How to Use an Enema and Nursing Care During Enema Administration:

The enema is in the form of a bag or container connected to a tube or nozzle. The bag contains a liquid or gas that is pumped into the rectum by applying pressure to the bag. The enema can be safely used by following these instructions:

• Ensure the doctor’s order for the enema and prepare the necessary equipment.
• Explain the procedure and its purpose to the patient.
• Assess the anal area for any tears, wounds, or ulcers.
• Wash hands and wear personal protective equipment.
• Gather the tools on the patient’s table in an easily accessible location.
• Ensure the patient is in a comfortable position, such as lying on their left side with their knees bent.
• Close the curtains and door to maintain the patient’s privacy.
• Choose a suitable location that provides enough space to lie down, with the bathroom being the most appropriate place for the enema.
• Remove the lower clothing of the patient.
• Spread a towel in a suitable place for the patient to lie down, ensuring they lie on their left side.
• Bend the knees toward the chest.
• Adjust the bed to an appropriate height and stand on the patient’s left side. Expose the anal area and cover the patient with a blanket, placing a protective plastic sheet underneath them.
• Monitor vital signs, particularly blood pressure, before starting the enema. Do not proceed with the enema if the blood pressure is lower than 60/90.
• Remove the cap from the enema nozzle.
• Apply medical gel to the tip of the tube to ease insertion.
• Administer the enema solution slowly, using a lubricated tube.

 

• Insert the enema nozzle into the rectum slowly and gently to a depth of 7–10 cm.
• Squeeze the liquid from the enema bag slowly until the bag is emptied completely.
• Remove the enema nozzle from the rectum gently.
• Wait for the enema to take effect, i.e., when the patient feels the urge to defecate.
• Ask the patient to hold the solution for the recommended duration, usually from 30 minutes to an hour.
• Encourage the patient to lie on their left side during the retention period to help ensure the solution reaches the target area.
• Monitor the patient for any negative reactions or side effects from the medication.
• Advise the patient to drink plenty of fluids to help soften the stool and promote bowel movement in the case of an oil enema.
• Monitor the GCS (Glasgow Coma Scale) to assess the patient’s level of consciousness.
• If the patient needs to defecate, direct them to the toilet to empty their bowels or place a bedpan under the patient.
• Record the amount and type of solution used, as well as the quantity and color of the stool. Assess the anal area for any bleeding or inflammation.