Introduction of a liquid solution into the rectum or sigmoid colon through the anus, with a cannula, for therapeutic or diagnostic purposes.
Objectives:
– To facilitate the evacuation of feces and gases. – To administer substances rectally to the patient so that they are absorbed by the intestinal mucosa.
Equipment:
– See rectal catheterization equipment. – See genital hygiene equipment.
– Irrigation system support. – Wedge. – Clamp forceps.
Material:
– See rectal catheterization material. – See genital hygiene material. – Solution to irrigate. – Irrigation system and support. – Soaker. – Waste bag. – Nursing records.
Procedure:
– Perform hand washing. – Prepare the material. – Check prescription and patient’s identity. – Prepare the prescribed solution with water at warm temperature. – Preserve the patient’s privacy. – Inform the patient of the procedure to be performed. – Ask for the patient’s and family’s cooperation. – Put on non-sterile gloves. – Place the patient in the left Sims position. This position facilitates the flow of the solution by gravity in the sigmoid and descending colon. – If it is a commercial preparation: Insert the cannula through the anus previously lubricated and fold the container on itself to empty it. – If it is not a commercial preparation, place the enema system on the support at a height of 30-35 cm above the anus. – Place the soaker under the patient’s hips and buttocks. – Connect the rectal probe to the irrigation system. – Flush the system and clamp it. – Perform rectal catheterization procedure. – Unclamp system and administer solution. Adequate temperature 37-40º Celsius. – Clamp and remove the catheter when the solution has been instilled. – If the patient does not retain or reports fullness close for 30 seconds and then continue. – Inform the patient that he/she should hold for 5-10 minutes. If it is a retention enema about 30 minutes or the prescribed time. – Facilitate access to the bathroom or place the wedge.
– Observe stool appearance. – Assist or perform genital hygiene. – Leave the patient in a comfortable position. – Collect the material. – Remove gloves. – Perform hand washing. – Record in the nursing documentation the procedure performed, reason, effectiveness, date and time, incidences and patient response.
Observations:
– The length of the probe to be introduced will be in adults 7-10 cm, in children 5-7.5 cm and in infants 2.5-3.5 cm. – The Harris enema is similar to the cleansing enema except: 1. The rectal probe is introduced 25-30 cm. 2. 500 c.c warm saline is administered. 3. The irrigation system is raised and irrigated until the flow stops or the patient feels discomfort. At this point the system is lowered below the patient’s buttocks, repeating no more than 3 times. – If the patient has fecal incontinence place a balloon rectal catheter. – Contraindications of the procedure: suspected intestinal obstruction, acute abdominal pain and cardiac patients.[/et_pb_text][/et_pb_column][/et_pb_row][/et_pb_section]
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