- HEPATITIS: inflammation of the liver

- MASTITIS: inflammation of the mammary gland in

the breast
- EUPNEA: normal breathing
- MENINGITIS: inflammation of the meninges, the
- APNEA: absence of breathing
membranes that line the brain and spinal cord
- DYSPNEA: difficulty in breathing
- POLIOMYELITIS: an infectious viral disease that
- HYPOXIA: decrease of oxygen in tissue (tissues are can cause paralysis
groups of cells that have a similar structure and act
- CHOLECYSTITIS: inflammation of the gallbladder
together to perform a specific function).
- ISTHMITIS: inflammation of the throat
- HYPOXEMIA: decrease of oxygen in blood
- PHLEBITIS: inflammation of a vein
- ASPHYXIA: condition caused by insufficient intake
of oxygen - GINGIVITIS: inflammation of the gum
- APHONIA: loss of voice - GLOSSITIS: inflammation of the tongue
- APHASIA: inability to speak - “ALGIA” word ending indicating pain
- ASCITIS: accumulation of fluid in peritoneal cavity - ARTHRALGIA: joint pain
(peritoneal cavity: the space within the abdomen that
- CEPHALGIA: headache
contains the intestine, the stomach, and the liver)
- MASTALGIA/MASTODYNIA: pain in breast
- ATAXIA: term for a group of disorders that affect
coordination balance and speech - MYALGIA: muscle pain
- “it is” word ending meaning inflammation - NEURALGIA: nerve pain
- APPENDICITIS: inflammation of the appendix - HEMATEMESIS: vomiting blood
(appendix to the large intestine)
- HYPEREMESIS: excessive vomiting
- ARTHRITIS: inflammation of the joint
- plegia: word ending, meaning – paralysis or stock
- BRONCHITIS: inflammation of the mucus
membrane in the bronchial tubes - paralysis: voluntary movement lost

- COLITIS: inflammation of the lining of the colon - MONOPLEGIA: paralysis of single limb or a single
(large intestine) group of muscles

- GASTROENTERITIS: inflammation of the mucus - HEMIPLEGIA: paralysis of one side of the body
membrane of the stomach and intestines - PARAPLEGIA: paralysis of the leg
- DIVERICULITIS: inflammation of one or more - QUNDRIPLEGIA: paralysis of all four extremities
diverticula
- PENTAPLEGIA: qundraplegia + respiratory
- PANCREATITIS: inflammation of the pancreas depression
- ENCEPHALITIS: inflammation of the brain - paresis word ending meaning incomplete or
- ENDOCARDITIS: inflammation of the endocardium partial paralysis
(innermost layer) - hemi means half
- PERICARDITIS: inflammation of pericardium - HEMIPARESIS: partial weakness on one side of the
(pericardium surround the heart and the roots of the body
great blood vessels)
- XEROPHTHALMIA: abnormal dryness of the
- CYSTITIS: inflammation of the urinary bladder conjunctive and cornea of eye or dry eyes
- DERMATITIS: inflammation of the skin - PHOTOPASIA: flashes of light
- TONSILITIS: inflammation of the tonsils - PHOTOPHOBIA: severe light sensitivity
- GASTRITIS: inflammation of the lining of the - DIPLOPIA: double vision
stomach
- EPHIPORA: excessive tearing
- STOMATITIS: inflammation of the mucus tissue of
the mouth
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- DIAGNOSIS: identification of a disease or a - BORBOYGMUS: rumbling, gurgling sound made by
condition movement of gas in intestine
- ANASTOMOSIS: a connection made surgically - leuko meaning white
between adjacent blood vessels, part of the intestine
- LEUKOCYTE: white blood cells
or other channels of the body
- LEKOPLAKIA: white plaques or patches of mouth
- megaly means large
mucosa
- SPLENOMEGALY: enlargement of the spleen
- SUBLINGUAL: under the tongue
- NEPHROMEGALY: enlargement of one or both
- APHAGIA: inability to swallow
kidneys (nephro = kidney)
- DYSPHAGIA: difficulty swallowing
- HEPATOPLENOMEGALY: enlargement of the liver
and spleen (hepatic = liver) - DYSPEPSIA: difficulty digestion (indigestion)
- PANCREATOMEGALY: enlargement of the - DYSPHASIA: difficult speaking
peripheral part of the body, especially the head, face,
hands, feet resulting from excessive secretion of - ODYNOPHAGIA: painful swallowing
growth hormone - MENORRHEA: menstrual bleeding
- HYDRONEPHROSIS: abnormal condition of water - AMENORRHEA: absence of menstrual discharge
on the kidney
- DYSMENORRHEA: painful menstruation
- hyper means above or high or excess
- LEUCORRHEA: whitish vaginal discharge
- hypo opposite of hyper, it means less than
normal - patent means open

- HYPERTHYROIDISM: excessive production of - non-invasive procedure: a diagnostic effort or

thyroid hormone treatment that does not require entering the body or
puncturing the skin
- HYPERLIPIDEMIA: an excess of fat or lipid in the
blood (hyperlipemia) - pace maker: an electronic device that is surgically
placed in the patient’s body and connected to the
- HYPERKINESIA: an abnormally increase in heart to regulate the heartbeat
muscular activity
- congenital: a disease or physical abnormality
- HYPERCALCEMIA: an abnormally high level of present from birth
calcium in the blood
- palpitation: a sensation in the chest caused by an
- HYPERURICEMIA: an abnormally high level of uric irregular heartbeat
acid in the blood
- prophylaxis: means prevention
- HYPERPYREXIA: abnormally high fever
- hemoptysis: coughing up of blood from the
- pyrexia means fever respiratory tract
- HYPERTHERMIA: unusually high body temperature - hemothorax: accumulation of blood and fluid in the
- CONSTIPATION: difficult or delayed defecation pleural space in the chest

- DIARRHEA: frequent discharge of liquid stool - pleura is the serous membrane enclosing the lungs
(feces) - effusion means collection of fluid in a closed activity
- DIVERTICULA: abnormal side pocket in hollow - pleural effusion: an abnormal accumulation of fluid
structure, such as intestine, sigmoid colon, and in the pleural space
duodenum
- pneumothorax: accumulation of air in the pleural
- FLATUS: gas expelled through the anus space
- HEMORRHOIDS: swollen or twisted veins – either - ECTOMY: surgical removal of something
outside or just inside the Anus
- ADENECTOMY: surgical removal of gland
- MELENA: feces containing blood (black tarry stool)
- ADENOIDECTOMY: surgical removal of the
- STEATORRHEA: excessive fat in feces adenoids

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- ADRENALECTOMY: removal of one or both adrenal - THORACOTOMY: making an opening into chest wall
gland
- LAPAROTOMY: incision made into the abdominal
- APPENDECTOMY: appendix wall for the purpose of examining abdominal organs
or diagnosing an abdominal problem
- AURICULECTOMY: ear removal
- TRACHEOTOMY: trachea (for inserting a tube to
- TYMPANECTOMY: eardrum
allow air flow the lungs)
- CHOLECYSTECTOMY: gall bladder
- CRANIOTIOMY: skull
- COLECTOMY: colon (large intestine)
- EPISIOTOMY: between vagina and anus to prevent
- CRANIECTOMY: portion of the cranium (skull tearing during the child birthing process
composed of two-part cranium and the mandible)
- GASTROTOMY: stomach (for the purpose of feeding
- CYSTECTOMY: urinary bladder an individual who is incapable of taking in food
through normal processes
- GASTRECTOMY: partial or full removal of the
stomach - HYSTERETOMY: uterus (caesarean section)

- HEMORRHOIDECTOMY: removal of a hemorrhoid, - PHLEBOTOMY: incision or puncture made into a

also called piles vein in order to draw blood

- HEPATECTOMY: liver - OSTOMY: surgical procedure that creates an

artificial opening for the elimination of bodily
- HYPOPHYSECTOMY: pituitary gland (also called waste
hypophysis)
- COLOSTOMY: surface of the skin and the colon, also
- HYSTERECTOMY: removal of uterus referred to as a large intestine stoma. (colon: large
- KERACTECTOMY: cornea of the eye intestine)

- MASTECTOMY: removal of one or both breasts - ILEOSTOMY: opening between the surface of the
skin and the ileum (small intestine)
- MYECTOMY: portion of muscle
- STOMA: artificial opening outside the abdominal
- MYOMECTOMY: fibroid afro the uterus, but the wall.
uterus is left intact
- NECROSECTOMY: dead tissue
- NAPHRECTOMY: kidney
- for the treatment of neonatal hyperbilirubinemia
- NEUROCTOMY: nerve
- cause unconjugated bilirubin to be mobilized from
- OOPHORECTOMY: ovaries the skin by structural isomerization to a water
- ORCHIETECTOMY: testicles soluble from (lumirubin) that can be excreted in the
urine
- OSTECTOMY: bone
- the aim of phototherapy is to decrease the level of
- PANCREATECTOMY: pancreas unconjugated bilirubin in order to prevent acute
bilirubin encephalopathy, hearing loss and
- PANCREATODUODENECTOMY: pancreas and
kernicterus
duodenum
- lamps emitting light between the wavelengths of
- PNEUMONECTOMY: lung
400 – 500 manometers are specifically used for
- POSTHECTOMY: commonly known as circumcision administering phototherapy as bilirubin absorbs this
wavelength of light. The light is visible blue light and
- RHINECTOMY: part or all of the nose contains no ultraviolet light
- SALPHINGECTOMY: fallopian tubes - phototherapy or light therapy: way of treating
- SPELENECTOMY: spleen jaundice

- TONSILECTOMY: tonsils - special lights help break down the bilirubin in the
baby’s skin so that it can be removed from his or her
- THYROIDECTOMY: thyroid gland body. This lowers the bilirubin level in your baby’s
- OTOMY: cutting or surgical incision blood
Purpose:
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- to support the care of babies with CONTRAINDICATIONS
hyperbilirubinemia
- Photosensitive conditions such as lupus
- to decrease infant serum bilirubin levels erythematous and xeroderma pigmentosum
- to maintain phototherapy treatment safely and - history of cutaneous malignancies
effectively
- patient on arsenic or ionizing radiation therapy
- to minimize infant-maternal separation and patient on photosensitizing drugs
facilitate breastfeeding
OBSERVATIONS:
LIGHTS USED IN PHOTOTHERAPY:
- all infants in newborn care receiving phototherapy
1. MICRO WHITE HALOGEN LIGHTS: should have a temperature, pulse, respiration rate
documented 4 hourly and prevent dehydration
- they deliver light via a quartz halogen bulb and
tend to become quite hot so should not be - if an infant requires continuous cardiorespiratory
positioned closer to the infant than the monitoring for other reasons, then, this should
manufacturers recommendations of 52 cm. The continue while under phototherapy
lights can continue to be bright despite having
- accurately document fluid intake (oral or iv) and
low irradiance levels
output
2. FLUORO: 2 BLUE AND 2 WHITE
- urinalysis and specific gravity should be checked 8
FLUORESCENT LIGHTS:
hourly
- BLUE LIGHTS IS THE MOST EFFECTIVE LIGHT
- assess and record stools
FOR REDUCING THE BILIRUBIN
SIDE EFFECTS
3. OHMEDA BILIBLANKET: BLUE HALOGEN
LIGHT: - increased insensible water loss
- uses a halogen bulb directed into a fiberoptic - loose stools
mat. There is a filter that removes the ultraviolet
and infrared components and the eventual light is - skin rash
a blue-green color - bronze baby syndrome
- Biliblankets are not to be used on infants less - hyperthermia
than 28 weeks gestation or infants with broken or
reduced skin integrity - upsets maternal baby interaction

4. MEDELA BILIBED BLUE FLUORESCENT - hypocalcemia

LIGHT:
- blue fluorescent tube is fitted into a plastic crib
with a stretched plastic cover over the top for the
baby to lie on - also called SONOGRAPHY
TYPES OF PHOTOTHERAPY UNIT - involves exposing part of the body to high-frequency
sound waves to produce images of the inside of the
1. SINGLE SURFACE UNIT
body
2. DOUBLE SURFACE UNIT
3. TRIPLE SURFACE UNIT - ultrasound examinations do not use ionizing
radiation
INDITCATIONS:
- because ultrasound images are captured in real
- Localized psoriasis: mainly on chronic plaques
time, they can show the structure and movement of
- Atopic dermatitis the body’s internal organs, as well as blood flowing
through blood vessels
- Folliculitis
WHY ULTRASOUND?
- Mycosis fungoides
- most widely used imaging technology worldwide
- Palmoplantar pustulosis
- popular due to availability, speed, low cost,
- Pityriasis alba
patient-friendliness (no radiation)
- Leukoderma

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- applied in obstetrics, cardiology, inner medicine, - ultrasound is better known for its diagnostic
urology, etc. capabilities, it was initially used for therapy rather
than diagnosis.
- ongoing research to improve image quality, speed
and new application areas such as intra operative - 1940s, ultrasound was performed to services
navigation, tumor therapy. similar to that of radiation or chemotherapy now
WHAT ARE SOME COMMON USES OF THE - ultrasonic waves emit heat that can create
PROCEDURE? disruptive effects on animal tissue and destroy
malignant tissue
- ultrasound examinations can help to diagnose a
variety of conditions and to assess organ damage
following illness
THE ULTRASOUND MACHINE:
- ultrasound is used to help physician’s evaluate
1. TRANSDUCER PROBE: sends and receives
symptoms such as:
the sound waves
1. pain 2. CENTRAL PROCESSING UNIT (CPU):
computer that does all of the calculations and
2. swelling
contains the electrical power supplies for
3. infection itself and the transducer probe
3. TRANSDUCER PULSE CONTROLS: changes
4. hematuria (blood in urine) the amplitude, frequency and duration of the
- ultrasound is a useful way of examining many of the pulses emitted from the transducer probe
body’s internal organs 4. DISPLAY: displays the image from the
ultrasound data processed by the CPU
- image the breasts and to guide biopsy of breast 5. KEYBOARD/CURSOR: inputs data and takes
cancer measurements from the display
6. DISK STORAGE DEVICE: (HARD, FLOPPY,
DOPPLER ULTRASOUND:
CD) stores the acquired images
- blockages to blood flow (such as clots) 7. PRINTER: prints the image from the
displayed data
- narrowing of vessels
In some ultrasound studies, the transducer is
- tumors and congenital vascular malformation
attached to a probe and inserted into a natural
APPLICATION OF ULTRASOUND IN OBSTETRICS: opening in the body:

● FOLLOW FETAL DEVELOPMENT 1. TRANSESOPHAGEAL ECHOCRDIOGRAM:

● DETECT PATHOLOGIES inserted to the esophagus to obtain images of
the heart
APPLICATION IN CARDIOLOGY: 2. TRANSRECTAL ULTRASOUND: inserted to
● BLOOD FLOW IN VESSELS the man’s rectum to view the prostate
● CONTRACTION, RHYTHM 3. TRANSVAGINAL ULTRASOUND: inserted to a
● BLOOD FLOW IN THE HEART woman’s vagina to view the uterus and
● ASSESSMENT OF CARDIAC PERFUSION ovaries

APPLICATIONS IN INNER MEDICINE: BENEFITS AND RISKS

● GALLSTONE ● BENEFITS:
● PERFUSION OF RENAL TRANSPLANT - most ultrasound scanning is noninvasive and is
HISTORY: usually painless

● LORD RALEIGH: theory of sound - ultrasound is widely available, easy to use and less
● PIERRE AND JACQUES CURIE: piezoelectric expensive than other imaging methods
effect - does not use any ionizing radiation
● LANGEVIN: First ultrasound generator using
piezoelectric effect - ultrasound scanning gives a clear picture of soft
● SOLOKOV: ultrasound for material testing tissues that do not show up well on x-ray images
- it is the preferred modality for the diagnosis and
monitoring of pregnant women and their unborn
babies

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- provides real time imaging, making it good tool for 11. In one basin, pour enough soap solution to
guiding minimally invasive procedures such as needle moisten the cotton balls.
biopsies and needle aspiration
12. Pour warm water over perineal area.
● RISKS:
13. With the sterile forceps take soapy cotton
- for standard diagnostic ultrasound there are no ball/warm water and gently clean the vulva using
known harmful effects on humans from to back method then discard. Repeat 3X (gently
pat episiotomy wound, do not rub). Using 7 strokes.
-ultrasound involves only sound waves (no radiation
danger) 14. Pour warm water over the perineal area.
- however, sound waves can increase body 15. Dry the vulva and perineum with dry cotton balls.
temperature
16. Remove bedpan. Dry patient’s buttocks
LIMITATIONS:
17. Put a clean perineal pad following aseptic
- ultrasound waves are disrupted by air gas; technique.
therefore, ultrasound is not an ideal imaging
18. Leave the patient comfortable and
technique for air-filled bowel or organs obscured by
change/arrange linens.
the bowel.
19. Discard receptacle for soiled pads and cotton.
- large patients are more difficult to image by
Remove gloves.
ultrasound because greater amounts of tissue
attenuate (weakens) the sound waves as they pass 20. Return all equipment to the utility room
deeper into the body.
21. Record/document color, amount of lochia, any
-ultrasound has difficulty penetrating bone and, unusual characteristic such as odor, nature of
therefore, can only see the outer surface bony episiotomy, etc.
structures and not what lies within. For visualizing
internal structure of bones or certain joints, other
imaging modalities such as MRI are typically used.

- process of dispersing a liquid (medication) into a

microscopic particle and delivering into lungs as
patient inhales through the nebulizer.
DEFINITION:
- It means cleaning and washing the external - it is used to liquefy and remove retained secretions
structure of the pelvic area and the genital area. from the respiratory tract
PURPOSE - most aerosol medication has broncho-dilating
effects and are administered by respiratory therapy
- To cleanse perineum
personnel.
- To prevent infection
PURPOSE:
- To provide comfort
● To relieve respiratory insufficiency due to
- To teach self-care and genital hygiene bronchospasm
● To correct the underlying respiratory
1. Perform hand hygiene. disorders responsible for bronchospasm
2. Prepare needed equipment and take to the bedside ● To liquefy and remove retained thick
secretions
3. Explain the procedure to the client ● To reduce inflammatory and allergic
4. Pull curtain or close room door. responses of the upper respiratory tract
● To correct humidify deficit resulting from
5. Position the client in dorsal recumbent position. inspired air by passing the airway during
the use of mechanical ventilation in
6. Drape patient accordingly.
critically and post-patients
7. Apply disposable gloves. ● When a person has a cute asthma attack
● When a person is in respiratory distress
8. Place patient on the bedpan. ● If a person is unable to use inhaler
9. Secure receptacles for soiled pads/cotton balls. ● If a person has stridor
● Respiratory congestions
10. Using pick-up forceps, place enough dry cotton ● Pneumonia
balls in one kidney basin.
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 ● Atelectasis 8. Instruct the client to exhale, take in a deep breath
● Asthma from the mouthpiece, and hold his breath briefly and
then exhale.
TYPES OF NEBULIZER:
9. Instruct client to breathe slowly and deeply
● Inhaler or meter-dose nebulizer
● Jet nebulizer 10. Encourage coughing exercise after the treatment.
● Ultrasonic nebulizer Provide bronchial tapping, if permitted.
FUNCTION: 11. Disassemble and clean nebulizer after the use
- a nebulizer is a device that uses a small compressor 12. Provide oral hygiene
to convert liquid medication into tiny droplets of mist
13. Wash hands
that can be inhaled directly into the lungs
- Since the medication goes straight to the lungs,
onset of the medication’s action often takes place

Normal Findings
- Uterine size should approximately equal the number
of weeks of gestation measurements may vary by
about 2 cm and examiners’ techniques may vary but
measurements should be about the same
Abnormal Findings
- Measurements beyond 4 cm of gestational age needs
to be further evaluated.

rapidly - Measurements greater than expected may indicate a

multiple gestation, polyhydramnios, fetal anomalies,
or macrosomia. Measurements smaller than expected
- this promotes quick symptom relief in the case of may indicate intrauterine growth retardation.
illnesses such as asthma, where fast relief desirable - Multiple gestation- is pregnancy with more than one
- also, it minimizes the risk of side effects of the baby at a time.
medication, preventing the medication from being - Examples include pregnancy with twins, triplets,
metabolized into a less effective from by the body. and quadruplets.
Assessment: - Multiple gestation- occurs in approximately three
percent of pregnancies. It is a type of high-risk
1. Assess clients v/s, respiratory status and heart rate
pregnancy. Delivering twins, triplets, or more
before treatment
requires extra care.
2. Check doctors order
- Polyhydramnios- is the excessive accumulation of
Planning amniotic fluid — the fluid that surrounds the baby in
the uterus during pregnancy.
3. Wash hands
- Polyhydramnios occurs in about 1 to 2 percent of
4. Assemble all the equipment
pregnancies
Implementation
- Fetal anomalies- refer to unusual or unexpected
5. Identify the client. Explain the procedure to the conditions in a baby's development during pregnancy.
client
- Fetal anomalies may also be known as congenital
6. Place the client in semi-fowlers position anomalies or birth defects.

7. Add the prescribed amount of medication or saline - Macrosomia- refers to growth beyond a specific
to the nebulizer threshold, regardless of gestational age.

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- Fundal Height during Pregnancy 5. Warms hands by rubbing together. (Cold hands can
stimulate uterine contractions).
- The fundus will be found above the symphysis pubis
at 12 weeks. 6. Use the palm for palpation not the fingers.
- The fundus will be found at the belly button DEFINITION: Daily cleansing of the
(umbilicus) at 20 weeks. infant.
- If the fundus is found in the midway point between
the symphysis pubis and belly button the patient is TYPES:
about 16 weeks. So, if you have a test question that a. Tub bath - uses baby tub instead of a wash
says: the fundus is found within the symphysis pubis basin.
and belly button, how far along is the patient? b. Sponge bath – uses wash basin filled with
warm water to sponge the infant clean.
Answer: About 12-20 weeks. As mentioned above,
after about 20-36 weeks the fundal height
measurement should almost match the gestational
age give or take 2 cm.
PURPOSE:
Example: If your patient is 26 weeks, what do you
expect the fundal height measurement to be? - to refresh the baby

Anywhere to 24 to 28 cm. The fundus at 36 weeks - to stimulate the circulation

should be at the xiphoid process.
- to prevent any skin infections
Around 37-40 weeks (around delivery) the fundal
- to closely observe the body for evidence of any
height actually decreases and slightly moves down
abnormalities and to note infant’s growth and
about 4 cm from the xiphoid process as the baby
development
drops into the pelvis for birth.
- to induce sleep
Fundal Height after Pregnancy
PROCEDURE:
- About 1 hour after birth the fundal height is at the
belly button. 1. In bathing, the eyes should be washed first, from
the inner aspect outward with a clean corner of the
- The fundus will decrease by 1 cm per day and you
damp washcloth for each eye. This prevents irritation
won’t be able to palpate it by day 10-14 because it has
and contamination of the lacrimal ducts. The face
entered back into the pelvic cavity. Therefore, 24
should then be washed gently.
hours after birth the fundus should 1 cm (or one
finger breadth) BELOW the belly button……48 hours 2. The infant should now be bathed, working
it should be 2 cm below the belly button. downward over the body. Soap reduces surface
tension and facilitates cleaning. Unless soap is
- At 7 days the fundus should be at the symphysis
contraindicated, the nurse should lather her palms
pubis.
and proceed to lather the infant beginning under the
- At 10-14 days the fundus should be back in the chin, to the folds of the neck, arms, anterior trunk and
pelvic cavity and can’t be palpated. legs. This area is then rinsed thoroughly with a warm
wet washcloth in the same sequence, then dried. The
- At 6 weeks the uterus will be back at its size before infant may then be turned on his side to have his back
pregnancy. and buttocks lathered, rinsed and dried. The cord
Leopold’s Maneuver area should not be moistened and is cared for as
described in “cord care.”
-Leopold’s Maneuver is preferably performed after 24
weeks gestation when fetal outline can be already 3. In all infants, the nurse must remember to clean
palpated. the genital area from front to back.

Preparation: a. Female – the labia majora are separated and

cleaned,
1. Instruct woman to empty her bladder first.
4. The sequence described above is the same for a tub
2. Place woman in dorsal recumbent position, supine or sponge bath.
with knees flexed to relax abdominal muscles. Place a
small pillow under the head for comfort. - The sponge bath is done with the infant lying in the
crib or incubator and a basin of water nearby. The tub
3. Drape properly to maintain privacy. bath is done with the infant in a supported reclining
position in the water. Newly circumcised babies
4. Explain procedure to the patient.
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should not be bathed in a tub until healing is PURPOSE:
complete. Infants also should not be placed in a tub
- to stimulate defecation and to treat constipation.
until the umbilical stump has dropped off.
(simple evacuate enema)
- It is important to keep the infant warm during the
- to soften had fecal matter (oil enema)
bathing procedure.
- to administer medication (sedative enema)
5. The infant should be diapered, dressed and covered
with a blanket. The bed is changed and the infant is - to protect and soothe the mucus membrane of
left in a safe position on his side. intestine and to check diarrhea (emollient enema)
- to destroy intestinal parasites (anthelminthic
enema)
- to relieve the gaseous distention (carminitive
- aim: management is safe, effective delivery of
enema)
treatment without discomfort or tissue damage and
without compromising venous access, especially if - to administer the fluid and nutrients (nutritive
long term therapy is proposed enema)
INDICATION: - to relieve inflammation (astringent enema)
- fluid and electrolyte replacement - to induce peristalsis (purgative enema)
- administration of medicines - to stimulate a person in shock and collapse
(stimulant enema)
- administration of blood/blood products
- to reduce the temperature (cold enema or ice
- administration of total parenteral nutrition
enema)
- hemodynamic monitoring, blood sampling
- to clean the bowels prior to x-ray studies,
ADVANTAGES: visualization of the bowel, surgery on the bowel or
delivery of a baby (saline enema)
- Immediate effect
- to make a diagnosis (barium enema)
- control over the rate of administration
- to establish regular bowel functions during a bowel
- patient cannot tolerate drugs/fluids orally
training program
- some drugs cannot be absorbed by any other route
DEFINITION:
- pain and irritation is avoided compared to some
- ENEMA is the instillation of solution into
substances when given SC/IM
recto-sigmoid colon
WHAT ARE THE SIGNS OF A GOOD VEIN:
PURPOSES:
- bouncy
- relieve constipation
- soft
- relieve fecal impaction
- above previous sites
- expel flatus
- refills when depressed
- lower body temperature
- visible
- facilitate administration of medications
- has a large lumen
- prepare for diagnostic procedures or surgery
- well supported
CLEANSING ENEMA, NSS, TAP WATER,
- straight HYPERTONIC, SOAP SUDS:

- easily palpable - stimulates peristalsis by:

● Irritating the colon or rectum and
● Distending the colon by the volume of
solution
- introduction of fluid into the lower bowel through SOAP SUDS:
the rectum for the purpose of cleansing or to
introduce medication or nourishment. ● Stimulates peristalsis by irritating the colon
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ISOTONIC: NSS - wash hands and apply clean gloves. Observe
appropriate infection control
● Volume stimulates peristalsis
● safest solution - provide client privacy
● for infants and children
- promote relaxation
HYPOTONIC SOLUTION/FLEET ENEMA:
POSITION THE CLIENT:
● Volume stimulates peristalsis
ADULT: SIMS (LEFT-LATERAL) or left-side lying with
● Do not repeat – water intoxication
right-knee flexed
HYPERTONIC SOLUTION/FLEET ENEMA:
(facilitate the flow of solution by gravity as sigmoid
● Promotes distention by drawing out water colon is on left side)
from circulating blood volume to the bowel
INFANT and CHILDREN: dorsal recumbent
● Not for young children and dehydrated client
- lubricate the rectal tube about 2 inches (5 cm)
RETURN FLOW ENEMA/HARRIS FLUSH
ENEMA/COLONIC IRRIGATION: - allow solution to flow through connecting tube and
rectal tube to expel air prior insertion. (prevent
● To expel flatus
introduction of air in colon)
RETENTION ENEMA:
- insert rectal tube 3-4 inches (7-10 cm) gently in
rotating motion (prevent trauma)
1. OIL RETENTION
INTRODUCE SOLUTION SLOWLY:
● Lubricates rectum and colon and softens stool
- raise solution container and open clamp to allow
(mineral oil, olive oil, or cottonseed)
fluid to flow ((to prevent sudden stimulation of
● Instruct client to retain enema 1-3 hours to
peristalsis)
enhance absorption of oil
- HIGH ENEMA: 18 inches above rectum ((the higher
the solution, the faster the flow and greater pressure
2. CARMINATIVE ENEMA:
in the rectum)
● To expel flatus
- LOW ENEMA: 12 inches above rectum
IF CLIENT COMPLAINS OF FULLNESS OR PAIN:
3. MEDICATED ENEMA:
- clamp and stop flow for 30 secs and restart at a
● Decreases Potassium Levels
slower rate
● Facilitates exchange of sodium ions for
potassium loss in large intestines (decrease intestinal spasm and premature ejection of
solution)
FOR LARGE VOLUME ENEMA
IF HIGH ENEMA:
- correct solution, amount, and temperature (42 C or
less) - change position to distribute solution well
- solution container IF LOW ENEMA:
- rectal tube or correct size - remain in left lateral
- tube clamp (left lateral (sigmoid) – dorsal recumbent
(transverse) – right side lying
- IV pole
IF ORDER IS CLEANING ENEMA:
FOR SMALL VOLUME ENEMA
- give order 3x alternate hypotonic and isotonic
- prepackaged container of enema solution with
lubricated tip (fleet enema) (prevent water intoxication)
PROCEDURES:
- Check the doctor’s order
- identify the client, verify, inform, and explain, NURSING DIAGNOSIS:
procedure
- diagnosis is a statement or conclusion regarding
the nature of phenomenon
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- clinical judgment about individual family, or
community responses to actual or potential health
problems/life process
- a nursing diagnosis provides the basis for selection
of nursing interventions to achieve outcome for
which the nurse’s accountable
- 13 domains:
1. HEALTH PROMOTION
2. NUTRITION
3. ELIMINATION EXCHANGE
4. ACTIVITY/REST
5. PERCEPTION OR COGNITION
6. SELF PERCEPTION
7. ROLE RELATIONSHIPS
8. SEXUALITY
9. COPING OR STRESS TOLERANCE
10. LIFE PRINCIPLE
11. SAFETY/PROTECTION
12. COMFORT
13. GROWTH and DEVELOPMENT
TYPES:
- actual nursing diagnosis
- risk nursing diagnosis
- health promotion nursing diagnosis
- possible nursing diagnosis
- syndrome nursing diagnosis

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