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BOWEL IRRIGATION . Prepared by Salwa Maghrabi. Outlines . Definition Indications Contraindications The procedure Equipments Preparation phase Procedural steps Complications Patient teaching . Objectives . Define the bowel irrigation .

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bowel irrigation

BOWEL IRRIGATION

Prepared by

Salwa Maghrabi

outlines
Outlines
  • Definition
  • Indications
  • Contraindications
  • The procedure
  • Equipments
      • Preparation phase
      • Procedural steps
  • Complications
  • Patient teaching
objectives
Objectives
  • Define the bowel irrigation .
  • Enumerate the indications of bowel irrigations.
  • Mentions the contraindications for bowel irrigations.
  • Understand and the ability t apply the procedure .
  • List the complications for bowel irrigations.
  • The ability to educate the patient regarding of bowel irrigation
definition
Definition

medical process involving the rapid administration of large volumes of an osmotically balanced polythelyen glycol solution (Golytely , Colyte), either orally or via a nasogastric tube , to flush out the entire gastrointestinal tract .

indications
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 pharmachomabenzoars .
contraindications and cautions
Contraindications and cautions.
  • Nausea and bloating , bowel with aspiration , anal irritation and discomfort secondary to diarrhea are common , vomiting with aspiration .
  • GI hemorrhage , bowel obstruction , perforation , ileus , absent gag reflex , uncontrollable intractable vomiting, hemodynamic instability or compromised unprotected airway .
  • Unstable patient or at risk for a depressed level of consciousness.
contraindications and cautions cont
Contraindications and cautions Cont’
  • Aggressive use of antiemetic may be required to control bleeding .
  • Polyethylene glycol electrolyte solution decrease the adsorptive capacity of activated charcoal and therapeutic drug .
  • the traditional method of installing air while auscultating over the epigastrum to confirm the placement is not reliable
the procedure
The Procedure
  • Equipment :
  • Small – bro gastric tube .
  • Enteral feeding bag .
  • Bedpan .
  • 2 to 8 L of a polyethylene glycol- balanced electrolyte solution . ( PEG – EBS ).
the procedure cont
The Procedure Cont’
  • Patient Preparation :
  • Insert a gastric tube .
  • Place the patient on up right position .
  • Procedural Steps :
  • Administer the PEG – EBS either orally or by gastric tube at 1 to 2 L / hr .
  • If vomiting occurs, slow the administration rate and gradually increase the rate as tolerated .
  • Continue administration of the solution until the rectal effluent is clear .
complications
Complications
  • Aspiration , nausea , vomiting , bloating , abdominal cramp or distention .
  • Hypoglycemia .
  • Rectal irritation .
patient teaching
Patient Teaching
  • Setting up on commode .
  • Frequent wiping may cause rectal irritation .
  • The procedure may take 4 to 6 hours to complete.
  • Additional liquid bowel movement may occur after completion of WBI .
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