Fleet Enema

FLEET ENEMA
ENEMA
An enema is an introduction of fluid into the lower bowel through the rectum for the purpose of cleansing or to
introduce medication or nourishment.

PURPOSE
 To stimulate defecation & to treat constipation ex: simple evacuant enema
 To soften hard faecal matter ex: oil enema
 To administer medication ex: sedative enema
 To protect and soothe the mucus membrane of intestine & to check diarrhoea ex : emollient enema
 To destroy intestinal parasites ex : anthelminitic enema
 To relieve the gaseous distention ex : carminitive enema
 To administer the fluid and nutrients ex: nutritive enema
 To relieve inflammation ex : astringent enema
 To induce peristalsis ex : purgative enema
 To stimulate a person in shock and collapse ex: stimulant enema
 To reduce the temperature ex : cold enema or ice enema
 To clean the bowels prior to x-ray studies, visualization of the bowel, surgery on the bowel or delivery of a baby
ex : saline enema
 To make diagnosis ex: barium enema
 To establish regular bowel functions during a bowel training programme
 To induce anesthesia ex : anesthetic enema
TYPES OF ENEMA
CLEANSING ENEMAS
Stimulate peristalsis through irrigation of colon and rectum and by distention
1. Soap Suds: Mild soap solutions stimulate and irritate intestinal mucosa. Dilute 5 ml of castile soap in 1000 ml of
water
2. Tap water: Give caution o infants or to adults with altered cardiac and renal reserve
3. Saline: For normal saline enemas, use smaller volume of solution
4. Prepackaged disposable enema (Fleet): Approximately 125 cc, tip is pre-lubricated and does not require further
preparation
OIL-RETENTION ENEMAS
 Lubricates the rectum and colon; the feces absorb the oil and become softer and easier to pass

CARMINATIVE ENEMA
 Provides relief from gaseous distention

ASTRINGENT ENEMA
 Contracts tissue to control bleeding
Different Enema Preparations/ Set up:
ENEMA SOLUTIONS IN STAINLESS CONTAINER:

ENEMA IS DISPOSBLE CONTAINERS:
ENEMA IN REUSABLE BAG
SILICONE DOUCHE FOR ENEMA ADMINISTRATION:
General Guidelines in Administering Enema

1. Fill water container with 750 to 1000 cc of lukewarm solution, (500 cc or less for children, 250 cc or less fro an
infant), 99 degrees F to 102 degrees F. Solutions that are too hot or too cold, or solutions that are instilled too
quickly, can cause cramping and damage to rectal tissues
2. Allow solution to run through the tubing so that air is removed
3. Place client on left side in Sim’s position
4. Lubricate the tip of the tubing with water-soluble lubricant
5. Gently insert tubing into client’s rectum (3 to 4 inches for adult, 1 inch for infants, 2 to 3 inches for children), past
the external and internal sphincters
6. Raise the water container no more than 12 to 18 inches above the client
7. Allow solution to flow slowly. If the flow is slow, the client will experience fewer cramps. The client will also be
able to tolerate and retain a greater volume of solution
8. After you have instilled the solution, instruct client to hold solution for about 10 to 15 minutes
9. Oil retention: enemas should be retained at least 1 hour. Cleansing enemas are retained 10 to 15 minutes.

FLEET ENEMA
Fleet® Enema is a saline laxative that provides reliable relief from occasional constipation without pain or
spasm. You may be constipated if you have three or fewer bowel movements in a week, and your stools are
hard, dry and difficult to pass.

OFFICIAL LIST OF STEPS FOR ADMINISTRATION OF FLEET ENEMA BASED ON USL-
NURSING SKILLS LAB CHECKLIST
1. Check the physician’s order regarding the amount and type of solution to be used.
2. Assemble all equipment needed:
· Solution as ordered by the physician
· Water-soluble lubricant
· Waterproof pad or rubber sheet
· Bath blanket
· Bedpan or commode
· Wash cloth, soap and water
· Toilet tissue
· Disposable gloves
3. Perform hand washing
4. Explain the procedure and purpose to the client
5. Ensure the client’s privacy
6. Place a waterproof pad under and put the rubber sheet in place.
· The waterproof pad will protect the bed.
7. Assist the client in assuming a side-lying (Sim’s) position. Drape the client. Make sure that the
buttocks and anus are exposed.
· Sims’ position facilitates flow of solution via gravity into the rectum and colon, optimizing retention
of the solution.
· Exposure of the buttocks minimizes unnecessary exposure promoting comfort and privacy as well
8. Wear gloves
9. Open the pre-packaged enema solution. Check if the tip is lubricated; if not, lubricate the tip: 2-3 inches
(5-7cm) with a water-soluble lubricant
Lubrication facilitates passage of the rectal tube through the anal sphincter and prevents injury to the
mucosa.
10. Lift the upper buttocks to expose the anus. Insert the tube, pointing downward, for about 3-4
inches or 7-10 cm into the rectum slowly and gently. Ask the client to take deep breaths while
inserting the tube.
· Good visualization helps prevent injury to tissues. The anal canal is about 1 to 2 inches (2.5 to 5 cm)
long. Insert the tube past the external and internal sphincters; further insertion may damage the intestinal
mucous membrane. The suggested angle follows the normal intestinal contour, helping prevent bowel
perforation.
· Taking deep breaths helps relax the anal sphincter.
11. Squeeze all the contents of solution into the container slowly.
12. Remove the container and ask the client to retain the solution for at least 5-15minutes.
· This amount of time usually allows muscle contractions to become sufficient to produce good
results
13. Remove gloves and discard.
14. When client has a strong urge to defecate, place him or her in a sitting position on a bedpan or assist
to commode or bathroom. Stay with the client or have call bell readily accessible to provide privacy
15. Wear clean gloves and assist the client in cleaning the anal region. Remove the bedpan carefully. Note
the character, color, consistency and amount of stool.
16. Discard the stool and cleanse the bedpan thoroughly.
Remove gloves
17. Place the client in a comfortable and safe position.
18. Remove all equipment from the client’s room. Keep all articles in their proper storage.
19. Wash hands again.
20. Record the time, type of solution, character, amount of stool and the client’s response to the procedure.

Fleet Enema

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FLEET ENEMA

3. Saline: For normal saline enemas, use smaller volume of solution

ENEMA IN REUSABLE BAG

SILICONE DOUCHE FOR ENEMA ADMINISTRATION:

General Guidelines in Administering Enema

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