Enema

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Author:
kris10leejmu
ID:
169702
Filename:
Enema
Updated:
2012-09-08 21:52:17
Tags:
Clinical Practice ll
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Description:
Clinical Practice ll
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  1. What is an enema?
    the introduction of fluid into the rectum
  2. What do we use an enema for?
    evacuation of feces, or as a means of administering nutrients, or medicinal substances, or opaque material in radiological examination of the lower GI tract
  3. What is constipation?
    • hard dry feces, small amounts passed less often than expected
    • may be difficult to pass, may cause straining
  4. What is obstipation?
    the passage of small amounts of watery feces around an impacted fecal mass
  5. Which is worse, constipation or obstipation?
    obstipation
  6. What is the purpose of an enema?
    • stimulate bowel activity
    • evacuate the large intestines
    • irrigate the colon
    • soften feces
  7. What are some reasons we would use an enema?
    • constipation and obstipation
    • certain diagnostic procedures
  8. What are some diagnostic procedures we would use an enema for?
    • colonoscopy
    • abdominal radiographs
    • lower GI series
  9. When would we not want to use an enema?
    • perforation of bowel
    • recent colon surgery
  10. What are some complications when using an enema?
    • perforation of colon, causing leakage of fluid into abdomen
    • vomiting if administered too fast
    • hemorrhage if colon is irritated
  11. What are the different types of enemas?
    • cleansing enema
    • retention enema
  12. What is a cleansing enema used for?
    designed to remove fecal material by the repeated administration of large volumes of enema solution
  13. What is a retention enema used for?
    material administered stays in the colon until the desired effects are obtained
  14. What is an anti-inflammatory retention enema used for?
    in a patient with inflammatory bowel disease
  15. What is a water retention enema used for?
    constipated patient
  16. What materials do we need to use an enema?
    • enema solution
    • enema container
    • tubing
  17. What temperature should the eneam solution be?
    room temperature
  18. What can we use as an enema solution?
    • tap water
    • isotonic saline
    • mild soap and water
    • petroleum oils
    • glycerin and water
    • commercial enema preparations
  19. What type of enema solution should we avoid in dogs and cats?
    phosphate enemas (Fleet)
  20. What can happen if we use a phosphate enema in a dog and cat?
    • can cause severe electrolyte disturbance which can cause hypernatremia, hypocalcemia, hypomagnesemia
    • can cause acid-base imbalance (metabolic acidosis)
  21. What do we need for an enema container?
    • bucket or bag for large animals
    • 60 - cc syringe for cats and small dogs
  22. What kind of tubing can we use?
    • soft red rubber urinary or feeding catheter
    • old IV tubing with flamed, rounded ends may be used for cats
    • soft rubber tubing up to 1 cm diameter with flamed end may be used for dogs
  23. What can we attach to the end of the tube to use for large volumes in dogss?
    funnel
  24. What is the two-person procedure?
    • one person restrains by holding the patient's head and collar
    • the other person holds the tail and administers the enema
  25. How do we do an enema?
    • with patient in standing position, insert lubricated tube into rectum
    • administer enema solution slowly
    • remove tubing from rectum
    • allow patient to evacuate
  26. How far to we insert the enema tube?
    at least 5 cm cranial to anal sphincter
  27. What might an obstipated patient require?
    frequent small enemas
  28. When we are giving an enema for treatment of poisoning, when do we stop?
    when the fluid runs clear
  29. What can we use to break up hard feces, and who is responsible for doing this?
    • sponge forceps
    • veterinarian, vet tech should not do this

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