An adult patient has orders for an enema. A nurse will
A.
Give the enema to the patient while he or she sits on the toilet.
B.
Insert the tip of the enema tube into the rectum pointing towards the umbilicus.
C.
Have the patient lie on the right side to facilitate the instillation of water.
D.
Chill the water to a temperature between 75°F and 85°F.
The correct answer and Explanation is :
The correct answer is B: “Insert the tip of the enema tube into the rectum pointing towards the umbilicus.”
Explanation:
When administering an enema, the tip of the enema tube should be inserted into the rectum with the tip pointed towards the umbilicus (belly button) to follow the natural curvature of the rectum and colon. This positioning minimizes discomfort and helps ensure that the solution is properly instilled into the lower colon.
Let’s break down why this is the correct approach:
- Anatomy Consideration: The rectum curves slightly towards the umbilicus. By inserting the enema tube in this direction, you reduce the risk of trauma to the rectal tissue, minimize discomfort, and promote the proper flow of the enema solution into the sigmoid colon.
- Common Mistake Avoidance: Inserting the tube at the wrong angle (such as directly upward or sideways) can lead to improper administration of the enema or even rectal injury, which could cause complications for the patient.
Why the other options are incorrect:
- A. Giving the enema while the patient is on the toilet is incorrect because the patient should be lying down for proper administration. This position ensures relaxation of the anal sphincter and maximizes the retention of the enema solution, promoting effective bowel movement.
- C. Having the patient lie on their right side is incorrect; the patient should lie on their left side (Sim’s position) to facilitate the natural flow of the solution along the colon. Lying on the left side uses gravity to help the fluid move in the right direction.
- D. Chilling the water to 75°F–85°F is incorrect. The solution should be lukewarm, around 105°F to avoid cramping and discomfort.
In summary, inserting the enema tip towards the umbilicus follows natural anatomical pathways, ensures safe delivery, and enhances the effectiveness of the procedure.