Oil retention enemas 2 lubricate the rectum and colon

•
Oil retention enemas #2
lubricate the rectum and colon. The feces absorb the oil and
become softer and easier to pass. To enhance the action of the oil, the patient retains the enema
for several hours if possible.
•
Carminative enemas #3
provide relief from gaseous distention.
•
Medicated enemas #4
contain drugs. An example is sodium polystyrene sulfonate
(Kayexalate), which is used to treat patients with dangerously high serum potassium levels.
This drug contains a resin that exchanges sodium ions for potassium ions in the large intestine.
Another medicated enema is neomycin solution, an antibiotic that is used to reduce bacteria in
the colon before bowel surgery.
o How to administer, complications, management of complications
•You will review the steps for enema administration in the skills lab.
•Sterile technique is unnecessary because the colon normally contains bacteria.
•However, wear gloves to prevent the transmission of fecal microorganisms.
•Explain the procedure, including the position to assume, precautions to take to avoid
discomfort, and the length of time necessary to retain the solution before defecation.
•If the patient needs to take the enema at home, explain the procedure to a family
member.
•Often the health care provider orders “enemas until clear.” This means that the enema
is repeated until the patient passes fluid that is clear and contains no fecal material. It is
often necessary to give as many as three enemas, but caution the patient against using
more than three. Excessive enema use seriously depletes fluids and electrolytes. If the
enema fails to return a clear solution after 3 times (check agency policy), or if the patient
seems to not be tolerating the rigors of repeated enemas, notify the health care

provider.
•Giving an enema to a patient who is unable to contract the external sphincter poses
difficulties. Give the enema with the patient positioned on the bedpan. Giving the enema
with the patient sitting on the toilet is unsafe because the curved rectal tubing scrapes
the rectal wall.[ See Box 46-8 on text p. 1108 Procedural Guidelines: Digital Removal of
Stool.]
•For a patient with an impaction, the fecal mass is sometimes too large to pass
voluntarily. If enemas fail, break up the fecal mass with the fingers, and remove it in
sections.
•Digital removal is a last resort in the management of severe constipation and is
practiced when all other methods have failed. The procedure is very uncomfortable for
the patient. Excessive rectal manipulation causes irritation to the mucosa, bleeding, and
stimulation of the vagus nerve, which results in a reflex slowing of the heart rate.
•Because of the potential complications of the procedure, a health care provider’s order
is necessary to remove a fecal impaction.