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whole bowel irrigation

  1. WHOLE BOWEL IRRIGATION
  2. WHAT IS WHOLE BOWEL IRRIGATION?  Medical process involving the rapid administration of large volumes of an osmotically balanced polythelyen glycol solution ( Golytely,Colyte) ,either orally or via nasogastric tube ,to flush out entire gastrointestinal tract.
  3. PURPOSE:  To prepare for diagnostic examination or before certain surgery  To relieve inflammation  To stimulate peristalsis  To supply fluid and electrolyte those are absorbed from intestine  To dilute and remove toxic agents  To reduce temperature in hyperpyrexia  To relieve fecal incontinence  To supply medications locally  To clean the colon of feces, gas and barium  To treat infection and other pathological condition of colon
  4. PREPARATION OF THE PATIENT & ENVIRONMENT  Explain the sequence of the procedure  Arrange the articles at the bed side  Provide privacy  Place the Mackintosh and towel under the patient  Place the patient in left later position  Keep the bucket on a low stool or receive the out flow of fluid  Remove the back rest and extra pillows
  5. EQUIPMENTS  Funnel and tubing with glass connection  Mackintosh and towel  Rectal tube placed in a kidney tray  Vaseline  Rag pieces in a container  Hot and cold water in jugs  Prescribed solution in jug  Paper bag  Bucket  Toilet tray if needed  Clean linen if needed  Bath thermometer
  6. PROCEDURE  Wash hands thoroughly  Prepare the solution at the required temperature  Attach the tubing and check for any leakage  Lubricate the tip of the rectal tube about 4 inches  Separate patient's buttocks to visualize anus clearly  Insert tip of tube about 4 to 5 inches  ower funnel below level of rectum  Empty return flow into bucket  Fill funnel again. Pour 200 to 300 ml of fluid each time  Raise funnel and allow fluid to run continuously  Repeat this process, till return flow is clear  Remove the rectal tube by using rag pieces
  7. GENERAL INSTRUCTIONS:  A cleaning enema should be given one hour before the colon irrigation  The bladder should be emptied before colonic irrigations  The temperature of the solution is kept constant throughout the procedure  Allow only 200 to 300 ml of fluid to run into the rectum at a time  Make sure that the return flow is not blocked  Use a smooth and flexible rectal tube and lubricate it well  Prevent air entry into the intestines  Stop the procedure temporarily the patient complaints of pain  Listen to the complaints of the patient and should not ignore any discomfort however small they may be
  8. PRELIMINARY ASSESSMENT  Doctors order for any specific precautions  Diagnosis of the patient  General condition of the patient  Self-care ability of the patient  Mental status to follow instructions  Any contraindications  Need for any extra help  Articles available in the unit
  9. INDICATIONS:  Substance will not bound by activated charcoal.  Medications that are slowly released over 12 to 24 hours.  Massive ingestion with a significant delay.  Toxic solid object.  Presence of pharmochomabenzoars.
  10. CONTRAINDICATION:  Rectal infection  Fistula in anus  Painful and bleeding hemorrhids  Painful skin lesions around the anus  Massive carcinoma or tumors of the rectum  Loose sphincter  Polypus and diverticula of the intestine
  11. COMPLICATIONS:  Nausea  Vomiting  Abdominal cramps  Blotting
  12. PREVENTION & MANAGEMENT  Health teaching  Adequate intake of diet & fluid  Adequate intake of fibre in diet  Establishing a habit pattern  Relaxation  Privacy  Posture  Exercise  Use of laxatives , suppositories & enemas
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