How to Give an Enema | Enema Administration Clinical Nursing Skills

Nurses may have to give an enema as part of their nursing responsibilities. It is important nurses learn how to give an enema properly to prevent too much patient discomfort. Enema administration is virtually painless as long as an experienced nursing professional gives the enema with good nursing skills. The process is important for patients who need to alleviate their bodies of toxins.

What is an Enema?

The process of administering an enema involves inserting fluid into the patient’s rectum to cleanse the lower intestines and colon to remove accumulated toxins and fecal matter. Nurses administer enemas to stimulate bowel movements in most cases, but there are several other reasons, which include colon cleansing, constipation treatment, excessive potassium and ammonia removal, medication delivery, alleviate bowel inflammation, and bowel preparation for surgery. The entire process takes 30 minutes to a couple of hours.

Types of Enema

• Cleansing Enema – This type of enema prevent the release of feces while the patient is in surgery. The process prepares the intestines of the patient for a colonoscopy or x-ray. This type of enema can be administered as a small volume or large volume cleansing enema.
• Carminative Enema – This type of enema releases tension or swelling in the colon and rectum. When waste builds and sits in the colon, a carminative enema allows the waste and toxins to leave the body.
• Retention Enema – This type of enema is used to administer medication and oil into the patient’s rectum. The types of oil and medications include nutritive, antibiotics, and anthelmintics.
• Return-Flow Enema – This type of enema provides an alternating flow of enema solutions between 100 and 200 mL into and out of the patient’s colon and rectum to stimulate peristalsis to propel food along the normal process.

Steps on How to Give an Enema

1. Wash the hands thoroughly with soap and warm water for a minimum of 15 seconds before beginning the procedure.
2. Gather the needed materials (enema bag or bulb, lubricant, gloves, enema solution, ramp clamp, and a towel).
3. Warm the solution before placing it into an enema bag or bulb to a temperature between 99 and 106 degrees.
4. Place a towel under the patient to collect any leakage during the procedure. Lay the patient in a position to receive the enema. The ideal positions for enema administration are the right side position, left side position, knee chest position, and on the back. It is advised that the patient remain in one of these positions to receive the enema for one-third of the time.
5. Lubricate the tip of the enema applicator before inserting it into the rectum of the patient. Ensure that the entire length of the enema tip is lubricated and that the opening of the tip remains free from clogs so that the solution flows freely when the time comes to administer the enema.
6. Insert the lubricated enema tip into the patient’s rectum and release the enema tubing clamp.
7. Monitor the patient for cramping as the enema solutions flows comfortably into the patient’s rectum. Signs of cramping may include abdominal muscle tension. If signs of cramping are notices while monitoring the patient, stop the flow and ask the patient to take several deep breaths. Continue the process once the patient becomes comfortable again.
8. Gently massage the patient’s abdominal area. Massage down the left portion of the patient’s abdomen then massage from left to right across the lower belly button. Continue to massage up the right portion of the abdomen then massage from right to left under the patient’s rib cage.
9. Remove the tip of the enema from the patient’s rectum once the device is empty. Ask the patient to remain in the current position until he or she has a strong urge for a bowel movement.
10. The patient may need assistance with walking to the restroom so the nurse should provide this help if needed. Many patients may have the ability to walk to the restroom on their own while the solution is still in the colon.
11. Ask the patient to massage the abdomen while the enema is being expelled from the body. Tell the patient to massage the area under the belly button from right to left, starting on the right side and from left to right under the patient’s rib cage. The massaging process helps to loosen fecal matter.
12. Dispose of the gloves used to administer the enema. Wash hands with soap and water after the process is complete.

Video on Enema Administration

Complications of Enema Administration

Complications from enema administration include muscle tone loss, fluid overflow, bowel irritation, internal hemorrhaging caused by an imbalance of electrolytes. An enema should not be administered to a patient with rectal bleeding, abdominal pain, prolapsed rectal tissue, myocardial infarction, or arrhythmias.

Nurses can learn to execute the simple process that can help their patients remove harmful toxins and fecal matter from their bodies safely and comfortably. Patients rely on the specialized care of nursing professionals to make them as comfortable as possible.