Bowel irrigation
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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

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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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