Purposes: Procedure:

-a bowel stimulant 1. Inform client about the procedure.

-relieve constipation and bowel impaction
-Cleansing the lower bowel prior to a surgical procedure
-General anesthetic agents for surgical purposes are
sometimes administered by way of an enema.
Types of Enema:
 Cleansing enema
 Oil-retention enema
 Medicated enema
 Carminative enema
Massaging the Abdomen : When receiving the enema
Massage abdomen in a counter-clockwise direction this
will help move the solution higher into the colon.
Massaging the abdomen also helps in relieving the
cramping sensation.
Guidelines;
2. Assemble articles needed.
3. If using an enema bag, fill it with 750 to 1000ml.
Warm water as it flows from the faucet. Check
temperature of water by pouring small amount
over inner wrist. Remove air from tubing by
allowing solution to fill tubing.
4. Clamp tubing
5. Assist client into left side-lying position with right
knee flexed. Encourage client to remain in
position until procedure is completed. Place
client in as comfortable and private an
environment as possible.
6. Place waterproof pad absorbent side up under
hips and buttocks.
7. Cover client with bath blanket, exposing only
rectal area and clearly visualize anus.
8. Lubricate 7.5 to 10 cm. (3-4in.) of tip of rectal
tube with lubricating jelly.
9. Gently separate buttocks and locate anus.
10. Instruct client to relax by breathing out slowly
through the mouth.
11. Insert tip of rectal tube slowly by pointing tip in
direction of clients umbilicus.
12. Hold tubing in rectum constantly until end of fluid
instillation.
13. With container at client’s hip level, open
regulating clamp and allow solution to enter
slowly.
14. Raise height of enema bag slowly to 30-45cm.
(12-18in.) above the anus. Infusion time varies
with volume of solution administered (1L may
take 7-10min.)
15. Hang container on IV pole.
16. Lower container or clamp tubing if client
complains of cramping or if fluid escapes around
rectal tube.
17. Clamp tubing after all the solution is infused.

Articles; Adult Children Infant

• Enema bag/ enema can
• Water proof absorbent underpads Size of Fr. # 22- Fr. # 14-18 Fr. #12
• Water-soluble lubricant Rectal tube 30
• Bedpan/bedside commode/access to toilet
• Wash basin, wash cloths, towel, and soap. Amount of 500- 250-500ml 250ml or less
• Toilet tissue solution 100ml.
• Bath blanket Distance of 7.5-10cm 5-7.5cm. (2- 2.5-3.75cm.
• Disposable gloves tube (3-4in.) 3in) (1-1.5in.)
• IV stand/pole insertion

Solution 40.5-43 C 37.7 C

temperature
 18. Tell client that the procedure is completed and
that you will be removing rectal tube. Then
gently remove rectal tube.
19. Explain to client that feeling of distention is
normal. Ask the client to retain solution as long
as possible (5-10mins.) while lying quietly on
bed.
20. Assist client to bathroom or commode if
possible.
21. Instruct client with a history of cardiovascular
disease to exhale while expelling enema to
avoid valsalva maneuver.
22. Assist client to wash anal area with warm soap
and water.
23. Do after care.

Recording;
• Client’s sign and symptoms
• Type of enema given
• Result including color, amount, and appearance
of stool.