ENEMA PROCEDURE

By:
Ni Luh Gede Sita Prahita Dani
13.321.1958
A7-E

PROGRAM STUDI ILMU KEPERAWATAN

STIKES WIRA MEDIKA PPNI BALI
TAHUN 2014/2015
Definition :

An enema is the insertion of a liquid into the rectum or colon by way of the anus.
The colon, also called the large intestine or large bowel, is a long, hollow organ in your
abdomen. It plays an important role in digestion by removing water from digested
material and forming feces ( stool ).

Preparation Tool :

1. Set the tool huknah / enema

2. Bath towels
3. Handscoen clean
4. Pot
5. Pedestal / waterproof
6. Vaseline / jelly
7. Kom, warm water, soap, and washlap
8. Tissue
9. Nierbeken / bent
10. Skort
11. Plastic trash

Enema Procedure :
1. Wash hands.
2. Wearing skort.
3. Wearing handscoen clean.
4. Prepare liquid huknah / enema:
a. Temperature ( 37C for the children and from 40,5 to 43C for an adult ).
b. The amount of fluid ( 150-250 ml for infant age, 250-350 ml for children aged
toddler, 300-500 ml for school-age children, 500-750 ml for children aged
adolescent, and 750-1000 to adulthood ).
5. Installing waterproof / pad under buttocks clients.
6. Setting up the pot at a position that is easily accessible by nurses.
7. Set the proper sleeping position clients:
a. Huknah Low : Sleeping position tilted to the left.
 b. Huknah Height : Side to the left, supine, then tilted to the right ( if possible ).
8. Connecting the rectal cannula with irigator hose.
9. Smearing cannula tip with vaseline / jelly along 3-4 inches or 7,5 to 10 cm.
10. Remove the air contained in irigator hose by removing fluid to freely irigator air hose
then hose clamps irigator in return.
11. Opening client buttocks clearly visible through the anal canal, while advocating the
client to relax with deep breathing.
12. Inserting a cannula into the rectum through the anus leads to the umbilicus carefully
along : infant = 2,5 to 4 cm, the children = 5 to 6,5 cm, adult = 7,5 to 10 cm.
13. Irigator height adjustment :
a. Huknah Low : 30 cm from the anus.
b. Huknah Height : 30-45 cm from the anus.
14. Open clamp and drain the fluid huknah / enema into the colon at speeds 75-100
ml/min, while recommends clients to hold up the entire fluid entry.
15. If the client complains of abdominal cramping or fluid out of the anus, lower altitude
irigator.
16. Hose clamp irigator after all the liquid into the colon.
17. Putting a paper towel on the cannula and then pull slowly and enter into a plastic
garbage.
18. Advise the client to hold the fluid remains in the colon for 5-10 minutes with a fixed
position lying in bed.
19. Explain to the client that uncomfortable feeling is normal thing.
20. If the client feels no urge to defecate, encourages clients to defecate in the shower, if
the client does not allow auxiliary defecate in bed by using a pot.
21. Observing the characteristics of fluid that comes out (amount, color and consistency
of stool).
22. Cleaning the anal area, the buttocks and the skin around it by using a tissue and
washlap and soap, then dry it with a towel.
23. Restoring back clothes and tidy up the client.
24. Provide a comfortable position according to the client.
25. Cleaning tools.
26. Washing hands.