448735588-Bowel-wash by Dr.Raafat (1).pptx

Nursing College

1. Bowel wash

2. Definition W a s hing o u t o f c o lon with large q u a n ti t ies of sol u tion, to clear colon of f ae c es.

3. Purposes T o pre p are c o lon for s p e cific s u rgic a l or diag n ostic proc e dures T o dilute a n d rem o ve toxic a g e n ts that m ay be pre s e n t i n large inte s tine T o reduce temperature in hy p erpyre x ia and heat stro k e T o s u p p ly fluid and ele c trolytes that are a b s o rbed from intestine T o stimulate peristalsis T o relieve inflamm a tion T o k e ep the indi v idu a l cl e an in c a se of fec a l in c o n tinen c e

4. Contraindications B l ee d i n g hemorrho i ds C h ron i c d i arrhoea R e ctal surgeries, infection Intestinal obst r uction R e ctal po l yps Mass i ve co l on carc i n o ma Lo o se an a l sph i ncter D e b i l i tati o n A n al fistula Intestinal diverticu l um P a i n ful skin l e si o ns around an u s

5. Solutions used P l a i n w a ter C o ld w a ter N S ,NaC o 3 sol u tion 1- 2% A n tiseptic sol u tion , si l ver n i t r ate 1 :5000  KM N O 4 1:50 Thymol 1:100  A l um 1:100 B o ric soluti o n 1- 2% T a n n i c ac i d 1: 1 00 Amount of s o lution u s ed 2 -3 li t ers or ti l l he return flow is clea r .

6. T emperature solution F o r cl e a n si n g p u rpo s e 1 4 F F o r red u ci n g temp e rature 8 - 90 F

7. Artic les T ray c o ntaini n g C o l o n i c l a va g e set w i th tubing & gl a ss conn e ction R e ctal tube A dult : 22-30 Fr Children :1 2 -18 Fr V ase l i n e R a g p i eces/tissue p a p e rs Mackintosh Jugs w i th hot & cold w a ter K i dn e y t r ay B u cket S o l u tions B e d p an w i th lid D u ster / towel P e rine a l toil e t t r ay C l ean d i sposa b le g l oves P l astic apron

8. Procedure C h eck the p atients chart for phys i ci a n ’ s order and any sp e cif i c i n structions E x p l a i n to the pati e nt ab o ut procedure and how he has to c o -op e rate W ash ha n ds and don gloves Pre p are so l uti o n at requ i red temperature Attach the tubing and the rectal tube w i th funne l . P o ur the s o l ution i n it and check for l e akage . Lu b ricate the t ip o f rectal tube with the funnel F i ll the funn e l w i th t he sol u tion a n d e x p e l the a i r from the tub i ng by al l o w i n g a sma l l amount of f l u i d i n to the ki d ney t r a y . P i nch tube or close it w i th cl a mp

9. Procedure Mai n tain the p a tient left lateral po s it i on & bring clo s e to t he ed g e of be d . Se p arate the patient ’ s b u t t o c k ’ s to vis u alize the a n us cl e arly a n d in s ert the tip o f tu b e a b o u t 4 in c h e s w h ile the p a tient e x h a les a d e ep bre a th. L o w e r the fun n el bel o w the le v el of rectum to allow flatus to get escape from rectum. R a ise the fun n el and allow the fluid to run in, c o ntinue to p o ur more fluid into fu n n e l before the funnel is empt y . Wh e n 2 - 3 ml of fluid h a s g o ne in s id e , pi nc h the tube b e fore the funn e l i s c om p letely em p ty a n d in v ert i t into the b u c k et a n d si p h o n o f f the fluid

10. Procedure Wh e n return flow ce a s e s, turn the fun n el uprig h t & pour more sol u tion, lower the funnel until air from t he t u b e h a s b e en ex p elled . T h en raise the fun n el & repe a t the pro c e d ure. T em p orarily stop t he pro c e d ure if the p a tient d e v e lops a n y di s c o mfort C o ntinue the pro c e d ure u n til all t he f luid ord e red h a s b e en giv e n or until the return f low it c lea r . Gently remove the rectal tube by p u ll i ng it through 3 - 4 la y ers of rag pie c es / t is s ue p a p e rs

11. Procedure Di s c a rd the tiss u e p a p e rs in the p a p e r bag. Pla c e the f un n el w ith tubing in t he kid n ey t r a y . A s si s t p a tient t o the toilet, c o mm o de or bed pan Bring the toilet tray & as s ist for perine a l c a re Ch a nge the bed linen if s oiled, give comfortable p o sition T a k e articles to util i ty room di s infe c t fun n el, tubin g , c a theter & b u c k et. Cle a n, dry &re p la c e. Rem o ve glo v es &wa s h ha n ds R e c o rd the type of proc e d u re & the res u lt with d a te & time in n u rses rec o rd .

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