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BOWEL IRRIGATION

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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  1. BOWEL IRRIGATION Prepared by Salwa Maghrabi

  2. Outlines • Definition • Indications • Contraindications • The procedure • Equipments • Preparation phase • Procedural steps • Complications • Patient teaching

  3. 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

  4. 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 .

  5. 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 .

  6. 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.

  7. 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

  8. The Procedure • Equipment : • Small – bro gastric tube . • Enteral feeding bag . • Bedpan . • 2 to 8 L of a polyethylene glycol- balanced electrolyte solution . ( PEG – EBS ).

  9. 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 .

  10. Complications • Aspiration , nausea , vomiting , bloating , abdominal cramp or distention . • Hypoglycemia . • Rectal irritation .

  11. 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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