Please enable JavaScript.
Coggle requires JavaScript to display documents.
Skill Procedures of Gastrointestinal System - Coggle Diagram
Skill Procedures of Gastrointestinal System
Rectal/Colonic Lavage
Definition
Introduction and withdrawal of fluid from lower bowels. It can be further classified as rectal or colonic lavage depending on the area to be cleansed
Purpose
To cleanse the lower bowel prior to examination or surgery
To remove toxic substances which can be absorbed into the blood stream e.g. in hepatic failure
Contraindications
Loose sphincter
Painful hemorrhoids/ fistula
Numerous polyps
Rectal infection
Nursing Process
Planning
Requirements
Prepare the solution and assemble the apparatus
Prepare patient
Instruct patient to breath in and out deeply
Ensure privacy
Offer the use of bedpan/urinal
Explain the procedure and its purpose to patient
Place patient in left lateral
Arrange protective sheet
Cover patient and expose only the anus
Implementation
Run fluid slowly to prevent sudden distension of intestinal wall &
pain
Introduce ~250-300ml then without allowing the funnel to completely empty, invert it and siphon the fluid into the receiving pail placed on the floor
Release tubing, hold funnel ~30cm from anus
Pinch the tube when flow stops and repeat procedure till the return fluid is clear
(Observe patient closely throughout procedure)
Insertion of tube
Lubricate 10-13cm of the end of catheter
Run the solution through apparatus to expel air
Pinch or clamp the tubing
Gently insert catheter 7.5-10cm into rectum for rectal lavage and between 12.5 - 15cm for a colonic lavage
Do not push against a constricted anal sphincter
Position patient upright on bedpan if possible before removal of catheter to aid return flow of fluid
Maintain the siphonage as the catheter is slowly withdrawn to allow fluid to drain off
Make the patient tidy and comfortable
Clear used items
Assessment
Confirm Dr’s order
Assess patient’s level of consciousness and ability to move
Assess the area is appropriate for the procedure
Evaluation
Observe for any adverse reactions
Exhaustion and collapse → increased and prolonged peristalsis
Abdominal pain, discomfort and diarrhea →fluid trapped in haustration of colon
Documentation
Report and record amount of fluid used and returned
Administration of Rectal Enema
Stimulates peristalsis by mechanically distending the colon & stimulating rectal wall nerves
Clean the colon / breaking up a fecal mass
Introduction of solution into the colon via anus, through the rectum into the colon
Indications
Relieve distension & promote expulsion of flatus
Lubricate the rectum/colon
Bowel preparation for diagnostic or surgical procedures
Soften hardened stool for removal
Impacted stool
Collection of feces in the rectum that forms a mass that becomes so large or hard that the client is unable to pass in voluntarily
Contraindications
Myocardial infarction
Acute abdominal condition
Appendicitis
Recent colon & rectal surgery
Caution
Arrhythmia
Cleasing Enema (High)
Positioning during administration
Left lateral – dorsal recumbent – right lateral
It allows the solution to follow the large intestine
Given to cleans as much of the colon as possible
Solution container usually held 12 –18 inches (approximately 30 cm) above the rectum
Cleansing Enema (Low)
Clean the rectum and colon
Maintain left lateral position during administration
Equipment
Administration
Documentation