retention enema

Patient care

The procedure and expected sensations are explained to the patient. Necessary equipment is assembled; the patient is draped for warmth and privacy and assisted into a left side-lying position with the right knee flexed (Sim's position). The tubing is cleared of air, and the small lubricated tube is inserted 3–4 in (7.5–10.0 cm) into the rectum and is not removed (unless absolutely necessary) until the procedure is completed. The fluid is allowed to flow very slowly, with stops made at intervals to aid retention. If the patient experiences an urge to defecate, the fluid flow is stopped until the urge passes. When the entire volume has been instilled, the tube is quickly withdrawn, the patient's buttocks are compressed together for a few minutes to prevent evacuation, and the patient is encouraged to retain the enema for at least 30 min. The type and amount of fluid instilled, the patient's ability to retain it, and the amount, type, and consistency of the returned fluid and stool are documented.