CLEANSING ENEMA

BY : TANTI A.B
elimination
Is process to eliminate the waste product of metabolism in
urine or bulk ( feces ) product

Factors influence elimination :

1. Diet / daily intake
2. Weather
3. Psychological condition
4. Intake fluid and electrolyte
5. Habit
6. Culture
7. Sick condition
8. Medication
CONSTIPATION
DEFINE : RETENT OF FECES ELIMINATION IN
COLON

o Alteration of feces elimination habit

Etiology of constipation
1. Lack of fiber intake in daily diet
2. Immobilization
3. Weakness / limitation / decrease of activity
4. Lost or decrease of consciousness
5. Tumor
6. Pile / hemorrhoid
7. Pain
8. Lack of fluid intake
9. profound the urge to eliminate of feces
10. After operation effect
Signs / symptoms
• 1. flatulence
• 2. fell sensation of fullness in stomach
• 3. distention abdomen / abdomen distended
• 4. decrease of bowel sound
• 5. Nausea
• 6. vomit
• 7. feel retention
• 8. un satisfied when defecate
• 9. hard, rigid, dry stool
• 10. pass stool : once in three days or more
• 11. restless
• 12. discomfort
• 13. pain on lower abdomen
• 14. belching / eructating
• 15. perspiration
• 16. lost appetite
• 17. halitosis / bad mouth odors
diagnoses
1. Constipation related to : lack of fiber intake in daily diet
2. Constipation related to immobilization indicated by :
hard, rigid, dry stool, distended abdomen, pain on lower
abdomen
3. Constipation related to profound the urge to evacuate
feces
intervention
1 motivate the client to take plenty of water
2. Suggest the client to take more fiber in daily diet ( more
fruits and vegetable )
3. Encourage the client to do mobilization according to
ability and tolerance
4. Collaborate with nutritionist for suitable diet.
5. Administer stool softener according to doctor ‘s
prescription
6. Give laxative according to doctor ‘s prescription
implementation
1. motivating the client to take plenty of water
2. Suggesting the client to take more fiber in daily diet
( more fruits and vegetable )
3. Encouraging the client to do mobilization according
to ability and tolerance
4. Collaborating with nutritionist for suitable diet.
5. Administering stool softener according to doctor ‘s
prescription
6. Giving laxative according to doctor ‘s prescription
7. Administering / performing / inserting cleansing
enema
Cleansing enema
Purposes ; low cleansing enema :
1. Evacuate feces
2. Constipation problems

Consideration :
1. Lean to the left position
2. Water level ; 500 – 750 ml
3. Level of irrigator position : 25-30 cm
4. Target :Descendent colon
High cleansing enema
Purposes ; high cleansing enema :
1. Before operation and certain diagnostic procedure

Consideration:
1. Position ; lean to the right / side lying to the right
2. Water level : 1000 – 2000 ml
3. Level of irrigator position : 45 – 50 cm high
4. Target ; ascendant colon
instruments
1. Complete irrigator
2. Irrigator ‘s can
3. Irrigator tube
4. Rectal cannule straight
5. Rectal cannule curve
6. Warm / Luke water with soap solution / normal saline solution, / N/S 0,9%
7. Bedpan
8. Toilet paper
9. Washing bottle
10. Under pad
11. Gloves
12. Infusion stand
13. Soiled linen basket
14. Extra blanket
15. Instrument’s tray
16. 4x4 gauzes
17. Clamps
18. Mask
19. apron
Nursing instruction
1. Lay down on your back
2. Remove your underwear under this blanket
3. Lift your buttock a bit, I’ll place this under pad and this bedpan
4. Roll your body to the left
5. I’ll place this under pad and this bedpan
6. Straighten your left leg
7. Fold your right knee on it
8. I will insert this canulle right now. Please take a deep breathing
and open you’re your mouth
9. If you feel you want to pass stool, please let me know. Hold it
until I’ll over you a bed pan
10. Well it’s finished already.
11. I will wash you now. / I will give you anal wash now
12. Do you feel comfort, now
DIALOGUE
1. EXCUSE ME, ( SIR, MADAM, MISS )

2. MAY I COME IN ? / CAN I COME IN

3. GOOD MORNING / AFTERNOON / EVENING ( SIR,

MADAM, MISS )

4. ARE YOU Mr / Mrs / Ms……………………..

( check the wrist band).
5. LET ME INTRODUCE MYSELF , MY NAME IS
………………I AM THE NURSE ON DUTY , THIS MORNING
SHIFT FROM 7 AM TO 3 PM

6. HOW ARE YOU THIS MORNING,

( SIR, MADAM, MISS )?

7. DO YOU HAVE ANY COMPLAINT ?

8. I SEE, LET ME INFORM YOUR DOCTOR LATTER.

9. IT’S TIME FOR ME TO GIVE YOU CLEANSING

ENEMA /
I AM GOING TO GIVE YOU CLEANSING ENEMA,
10. BECAUSE YOU HAVE CONSTIPATED
BECAUSE YOU HAVE A BOWEL PROBLEM
BECAUSE YOU WILL BE OPERATED
IT IS YOUR THERAPEUTIC REGIMENT/ YOUR
DOCTOR ORDER

11. IT’S PURPOSED TO EVACUATE FECES AND TO

EMPTY YOUR COLLON

10. DO YOU AGREE ?

11. IF SO PLEASE SIGN HERE FOR INFORM CONSENT

1. Lay down on your back
2. Remove your underwear under this blanket
3. Lift your buttock a bit, I’ll place this under pad and this bedpan
4. Roll your body to the left
5. I’ll place this under pad and this bedpan
6. Straighten your left leg
7. Fold your right knee on it
8. I will insert this canulle right now. Please take a deep breathing and open
you’re your mouth
9. If you feel you want to pass stool, please let me know. Hold it until I’ll
over you a bed pan
10. Well it’s finished already.
11. I will wash you now. / I will give you anal wash now
12. Do you feel comfort, now
13. IF you have any problems please inform me / let me know
14. I am at nurse station
15. Thank you for your good cooperation
Nurse : Lay down on your back
Remove your underwear under this blanket
Lift your buttock a bit, I’ll place this under pad and
this bedpan. I will set your position to right sim
position, Roll your self to the right please, and flex your
knees
Roll your body to the left
Straighten your left leg
Fold your right knee on it
I will insert this canule right now. Please take a deep
breathing and open you’re your mouth
If you feel you want to pass stool, please let me
know. Hold it until I’ll over you a bed pan
Well it’s finished already.
Do you feel comfort, now. If there any complaint please
call me.
 Nurses note
Name : Ward :
Age : Room :
Date / day / notes Name /
time signature
Performed / inserted low cleansing enema,
Left Sim position, amount of water 500 ml,
with warm water and soap solution, running
well

Patient expressed comfortable.

Stool “:
Amount : 500 mg
Color : Dark Brown
Smell : Sting
Consistency : dry, hard, rigid