Elimination enema
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| _____ enema is intended to remove feces. It is given chiefly to prevent the escape of feces during surgery, prepare the intestine for certain diagnostic tests such as x-ray or colonoscopy and to remove feces in instances of impaction or constipation. | cleansing enema
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| The four different types of solutions for cleansing enemas are | hypertonic, hypotonic, Isotonic, Soapsuds, Oil (mineral, olive or cottonseed)
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| ___ solution exerts osmotic pressure, which draws fluid from the interstitial space into the colon. This increased volume in the colon stimulates peristalsis | hypertonic solution
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| A common hypertonic solution used is | Fleet phosphate enema
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| _____ solution exert a lower osmotic pressure than the surrounding interstitial space. Before the water moves from the colon, it stimulates peristalsis and defecation. | Hypotonic (tap water). Because the water moves out of the colon, the tap water should not be repeated b/c of danger of circulatory overload when the water moves from the interstitial space into the circulatory system.
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| _____ solution is considered the safest enema to use. They exert the same osmotic pressure as the interstitial fluid surrounding the colon. No fluid movement into or out of the colon. This normal saline stimulates peristalsis. | Isotonic (normal saline).
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| _____ stimulate peristalsis by increasing the volume in the colon and irritating the mucosa. | Soap sud (only pure soap- castile) should be used to minimize mucosa irritation)
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| Cleansing enema may be described as high or low. During the high administration, the patient should be in what position? | The high cleansing solution is to clean the colon as much as possible. The client will need to change from the left lateral position to the right lateral position to follow the large intestine.
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| The low cleansing enema is used to clean only | the rectum and sigmoid colon only. The client maintains a left lateral position during administration.
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| A ______ enema is given primarily to help relieve abdominal distention by expelling flatus (gas). For an adult 60-80mL is instilled. | Carminative enema (AKA return-flow enema)
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| A _______ enema introduces oil or medication into the rectum and sigmoid colon. The liquid is retained for a long period (1-3hrs). It acts to soften the feces and to lubricate the rectum and anal canal. | Retention enema
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| Enemas for adults are usually given at ____ - ______ temperatures. | 40-43C (105-110). High temps can injure bowel mucosa. Cold temps are uncomfortable and may trigger a spasm of the sphincter muscles.
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| The force of flow of the solution is governed by | 1) height of solution container 2) tube size 3) viscosity of fluid 4) resistance of the rectum
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| The solution container for adults should be no higher than ____ inch above the rectum. | 12. During high cleansing enema it is held 12-18 inches to instill farther.
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| When assessing the client what should you ask or look for prior to giving an enema? | 1) Last bowel movement 2) presence of abdominal distention 3) whether the client has sphincter control 4) can the client use toilet, commode, remain in bed or use a bed pain.
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| What should you consider prior to giving a hypotonic solution | whether or not the client has cardiac or kidney disease.
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| When inserting the enema, where should you direct the tube? | Towards the umbilicus
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| How far would you insert the tube? | 3-4 inches. The anal canal is 1-2 inches long in the adult, insertion to this point places the tip of the tube beyond
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| If resistance is encountered at the internal sphincter, what should you ask the client to do? | Take a deep breath and then run small amount of solution through the tube. This relaxes the internal sphincter. Never force it, if the internal sphincter does not allow you to advance the tube, remove it.
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| If a client complains of fullness or pain, what should you do? | lower the container or use the clamp to stop the flow for 30 seconds.
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| When giving a return flow enema, how should the container be held once the fluid has been inserted | the container should be lowered so that the fluid flows back out pulling the flatus with it.
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| The female urethra is ___ long, the males is ___ long | female - 1.5 inches, male- 8 inches
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| Urine collects in the bladder until pressure stimulates stretch receptors. This occurs when the adult bladder contains between ____ to ___ mL of urine. | 250-450 mL
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| Average daily urine input for an adult | 1200-1500 mL
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