If the patient experiences pain or

If the patient experiences pain or if resistance is felt at any time during the procedure, the nurse should stop the procedure and confer with the practitioner. Increasing the force during enema administration may lead to painful colon distention. The enema tube is to be inserted a maximum of 7.5 to 10 cm (3 to 4 in) in an adult. The patient should not bear down and then relax the rectal sphincter because this causes the enema tip to be expelled.

Stool softeners are the recommended initial treatment for constipation in children. An oil-based commercial enema is not appropriate for a child because the amount instilled is based on the child’s weight and may cause other complications. A prepackaged hypertonic solution enema is contraindicated for children because it may cause a rapid fluid shift. A physiologic normal saline enema may be appropriate for a child, but it is not the recommended initial treatment for constipation.
Enemas are contraindicated following recent prostate surgery because they may cause bleeding and discomfort. Because all enemas are contraindicated following recent prostate surgery, the type ordered is insignificant. An enema is not the appropriate initial step when bowel sounds are normal in quality and quantity, representing postoperative return of normal peristalsis; however, prostate surgery is the most important reason to question the enema order for this patient.