Administering a rectal suppositary.pptx

administeration m

1. Administering a Rectal Suppository Presented By Mrs.Usha Rani Kandula , MSc(N), Assistant professor in Adult health nursing, Department of Clinical nursing, Arsi University, College of health sciences, Asella , Ethiopia, Institutional email: [email protected].

2. Rectal Instillations -Rectal instillations can be in the form of enemas, suppositories, and ointments. - Rectal ointments are used to treat local conditions and symptoms such as pain, inflammation, and itching caused from hemorrhoids . -Rectal suppositories are cone-shaped masses of substances designed to melt at body temperature and to produce the intended effect at a slow and steady rate of absorption.

3. -Suppositories provide a safe and convenient route for administering drugs that interact poorly with digestive enzymes or have a bad taste or odor . -They are also used to provide temporary relief for clients who cannot tolerate oral preparations: for example, to relieve nausea and vomiting. -Suppositories are also used to induce relaxation, relieve pain and local irritation, reduce fever, and stimulate peristalsis and defecation in clients who are constipated.

4. -Rectal suppositories are contraindicated in cardiac clients because insertion may stimulate the vagus nerve, causing cardiac dysrhythmias (abnormal heart patterns). -These drugs are also avoided in clients recovering from rectal or prostate surgery because they may cause pain on insertion and trauma to the tissues. -The nurse should assess the rectum for irritation or bleeding and check sphincter control. - Some clients may experience problems in retaining the suppository.

5. -The nurse should instruct such a client to remain in the Sims’ position for at least 15 minutes or should place the client on the abdomen, if the condition allows, and hold the buttocks closed. -The health care practitioner should be notified when the client is unable to retain a suppository so that another route can be ordered. - Suppositories are often stored in the refrigerator to preserve the integrity of the drug form.

6. -A softened suppository is difficult to insert; to harden a suppository, place it under cold running water while it is still in its original wrapper. -The nurse should follow the rights of medication administration and Standard Precautions when administering rectal instillations.

7. Equipment Medication administration record (MAR) Prescribed rectal suppository Water-soluble lubricant (such as K-Y jelly) Non sterile gloves Tissue Bedpan (optional)

8. Sl.No Action Rationale 1 Check with client and the chart for any known or medical conditions that would contraindicate use of the drug. Prevents occurrence of adverse drug reaction. 2 Gather necessary equipment. Promotes efficiency. 3 Check MAR against written health care practitioner orders. Ensures accuracy in identification of the medication. 4 Wash your hands Reduces the transmission of microorganisms. 5 Check the client’s identification armband. Ensures correct client.

9. Sl.No Action Rationale 6 Ask client if he or she needs to void. Client will have to remain in bed after insertion of suppository. 7 Explain procedure to client. Enhances cooperation. 8 Don non sterile gloves. Decreases contact with body fluids. 9 Place the client in the Sims’, left-lateral position, with the upper leg flexed. Exposes anus and helps rectal sphincter relax. 10 Fold back the bed linen to expose the rectum. Provides privacy.

10. Sl.No Action Rationale 11 Open the package of lubricant and remove the foil wrapper from the suppository. -Read the manufacturer’s instructions on the wrapper for the recommended time interval the client should retain the suppository after insertion. Manufacturer’s instructions provide important information as part of the instructions for the client. 12 Apply a small amount of lubricant to the smooth rounded end of the suppository to reduce mucosal irritation. -Lubricate the gloved index finger. Lubricant facilitates insertion and reduces friction or pain as the suppository is inserted into rectum. 13 Instruct the client to breathe through the mouth. Relaxes sphincter and reduces chance of pain.

11. Sl.No Action Rationale 14 Insert the suppository into the rectal canal beyond the internal sphincter, about 4 inches (10 cm) for an adult and 2 inches (5 cm) for a child (Figure 29-38). -Avoid inserting the suppository into feces. Prevents the suppository from slipping out. Suppository must be placed next to mucosa to facilitate absorption and enhance therapeutic action of the drug. 15 Withdraw the finger and wipe the anal area with tissue. Provides comfort. 16 Instruct the client to remain in bed for 15 minutes and to resist urge to defecate. Allows medication to be absorbed and prevents expulsion of the suppository. 17 Remove gloves, turning them inside out; dispose of gloves; wash hands. Reduces transmission of microorganisms. 18 Record on the MAR the name of the drug, dosage, route, and time of administration. Provides documentation that medication was given.

12. Sl.No Action Rationale 19 Observe for effect of suppository after administration. Evaluates effectiveness of medication. Thanking you