bowel irrigation prepared by salwa maghrabi. outlines 1. definition 2. indications 3....
TRANSCRIPT
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BOWEL IRRIGATION
Prepared by Salwa Maghrabi
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Outlines 1. Definition2. Indications3. Contraindications4. The procedure 5. Equipments
Preparation phase Procedural steps
6. Complications 7. Patient teaching
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Objectives 1. Define the bowel irrigation .2. Enumerate the indications of bowel
irrigations.3. Mentions the contraindications for
bowel irrigations.4. Understand and the ability t apply the
procedure .5. List the complications for bowel
irrigations. 6. The ability to educate the patient
regarding of bowel irrigation
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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 .
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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 .
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Contraindications and cautions .1. Nausea and bloating , bowel with
aspiration , anal irritation and discomfort secondary to diarrhea are common , vomiting with aspiration .
2. GI hemorrhage , bowel obstruction , perforation , ileus , absent gag reflex , uncontrollable intractable vomiting, hemodynamic instability or compromised unprotected airway .
3. Unstable patient or at risk for a depressed level of consciousness.
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Contraindications and cautions Cont’
4. Aggressive use of antiemetic may be required to control bleeding .
5. Polyethylene glycol electrolyte solution decrease the adsorptive capacity of activated charcoal and therapeutic drug .
6. the traditional method of installing air while auscultating over the epigastrum to confirm the placement is not reliable
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The Procedure Equipment :1.Small – bro gastric tube .2.Enteral feeding bag .3.Bedpan .4.2 to 8 L of a polyethylene glycol-
balanced electrolyte solution . ( PEG – EBS ).
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The Procedure Cont’Patient Preparation :1.Insert a gastric tube .2.Place the patient on up right position .
Procedural Steps :1.Administer the PEG – EBS either orally or
by gastric tube at 1 to 2 L / hr .2.If vomiting occurs, slow the administration
rate and gradually increase the rate as tolerated .
3.Continue administration of the solution until the rectal effluent is clear .
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Complications 1. Aspiration , nausea , vomiting ,
bloating , abdominal cramp or distention .
2. Hypoglycemia .3. Rectal irritation .
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Patient Teaching 1. Setting up on commode .2. Frequent wiping may cause rectal
irritation .3. The procedure may take 4 to 6 hours to
complete.4. Additional liquid bowel movement may
occur after completion of WBI .
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