Suppositories and Enemas

Transcription

1 Suppositories and Enemas Training Components Indication for use of suppository and enemas Prior to administering medication (8 Rs) Precautions Proper insertion technique Suppository Enema Storage Indication for use of suppository and enemas A rectal suppository is a drug delivery system that is inserted into the rectum, where it dissolves or melts and is absorbed into the bloodstream. They are used to deliver both systemically and locally acting medications to treat conditions such as: Constipation Pain Haemorrhoids Inflammatory bowel disease Bowel evacuation An enema, is a fluid injected into the lower bowel by way of the rectum. The most frequent use of an enema is as a cleansing enema given: to relieve constipation for bowel cleansing before a medical examination or procedure 1

2 Prior to administering a suppository or Enema-the 8Rs Right Patient- Ensure right client for right suppository/enema Right Drug-Check name of suppository/enema against the MAR Right Dose- Check strength of medication against MAR Right Route-Rectally/vaginally Right Time-Timing of administration check against MAR and bowel protocol Right Reason-Understand indication and signs and symptoms on using PRN Right Documentation- Sign on MAR after administering Right Response-Observe patient response to medication *Also Check: Expiration date of suppository/enema *MAKE sure to Document on MAR the above information Precautions Unexplained abdominal pain, nausea, vomiting, NEW rectal bleeding, Signs of Impaction SHOULD BE OBSERVED PRIOR TO ADMINISTRATION AND BROUGHT TO THE ATTENTION OF A PHYSICIAN Enemas: history of heart failure, kidney disease, high blood pressure, GI obstructions, inflammatory bowel disease, severe dehydration Suppositories 2

3 1. Wash your hands thoroughly with water and soap and apply disposable latex gloves or a finger cot Germs and other bacteria are capable of invading the immune system through the rectum if given the chance For this reason, it's recommended to wash your hands, even if you'll be wearing gloves during the procedure If your nails are long, you might want to cut them to avoid scratching or injuring the rectal lining Use latex gloves to protect your hands and client during the application 2. Read the instructions There are several laxative products available that differ in the way they are applied or on the dosage needed. If you are using a prescription laxative, follow the instructions you received from your health care provider and never exceed the recommended dose. If you don t need to take a full dose, cut the suppository in half lengthwise. A lengthwise cut makes insertion much easier than a sideways cut. 3. Remove suppository from foil wrap and ensure suppository rigid and at room temperature If the suppository is too soft, it might be difficult to insert it. For this reason, you CAN harden it before insertion. Before removing the wrapper: Place it in the refrigerator or freezer for up to 30 minute Hold it under cool running water for several minutes 3

4 4. Lubricate the area around the anus with water soluble lubricant Lubricate the: surrounding skin to ease the application the suppository if not already lubricated the gloved finger that will be used to insert the suppository 5. POSITIONING IS KEY Best way to insert the suppository is to do it while lying down. Lie the individual on the left side and pull the right leg upward towards the chest. 6. Insert the suppository into the rectum CHECK ANAL REGION FOR ANY SIGNS OF BLEEDING OR NEW FISSURES/HEMMOROIDS 1. To make the insertion easier, lift the right (upper) butt-cheek up to expose the rectum 2. Insert the suppository lengthwise to make for easier passage 3. Push it in using index finger for adults or pinkie for younger children TIPS: 1. For adults, aim to push the suppository at least 1 inch into the rectum. For children, aim to push the suppository at least ½ to 1 inch into the rectum 2. make sure to insert past the sphincter. If the suppository is not inserted past the sphincter, it may eventually come out instead of being delivered by the body 4

5 7. Hold the buttocks together tightly for a few seconds after insertion this will help keep the suppository from sliding out Keep the patient or yourself lying down for several minutes after insertion. 8. Wait for the medicine to take an effect Depending on the suppository, it usually takes between 15 to 60 minutes to take an effect and cause a bowel movement. 9. Remove gloves and wash your hands completely Use warm water and soap and be sure to rub the soap in for at least 30 seconds and then rinse off properly 5

6 Enemas (Mineral Oil, Sodium Phosphate) 1. Wash your hands thoroughly with water and soap and apply disposable latex gloves or a finger cot Germs and other bacteria are capable of invading the immune system through the rectum if given the chance For this reason, it's recommended to wash your hands, even if you'll be wearing gloves during the procedure If your nails are long, you might want to cut them to avoid scratching or injuring the rectal lining use latex gloves to protect your hands and client during the application 2. Read the instructions There are several laxative products available that differ in the way they are applied or on the dosage needed. If you are using a prescription laxative, follow the instructions you received from your health care provider and never exceed the recommended dose. 6

7 3. Remove cap protective shield from enema 4. Lubricate the area around the anus with water soluble lubricant Lubricate the: Surrounding skin to ease the application The enema tip if not already lubricated 5. POSITIONING IS KEY Best way to insert the enema is to do it while lying down. Lie the individual on the left side and pull the right leg upward towards the chest. 7

8 6. Gently insert the enema tip into rectum With steady pressure, gently insert enema tip into rectum with a slight side-to-side movement, with tip pointing toward navel, approx. 3.5inches TIPS: Insertion may be easier if person receiving enema bears down, as if having a bowel movement. This helps relax the muscles around the anus. Do not force the enema tip into rectum as this can cause injury. CHECK ANAL REGION FOR ANY SIGNS OF BLEEDING OR NEW FISSURES, HEMORRHOIDS 7. Squeeze bottle until nearly all liquid is gone It is not necessary to empty the bottle completely, as it contains more liquid than needed. 8. Remove enema from rectum and maintain position Wait for the medicine to take an effect maintain position until urge to evacuate is strong (usually 2 to 5 minutes) 8

9 9. Remove gloves and wash your hands completely Use warm water and soap and be sure to rub the soap in for at least 30 seconds and then rinse off properly Storage Suppositories: Store at room temperature, in a slightly cool area Too warm: suppository will melt making it difficult to insert Too cold: suppository will take longer to dissolve in the rectum thus delaying time for the medication to take effect Enemas: Room temperature away from children No need for warming/cooling before administration Demonstration Please grab a partner and verbally demonstrate to one of the instructors proper administration of a suppository and enema 9

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