Can someone explain this statement to me?

[Nuieve]

The question is about stimulating bowel movement in an unconscious patient.

Rationale says that "enemas may be needed on an every other day basis but they are used cautiously (may even be contraindicated) because the Valsalva maneuver can increase intracranial pressure".

I have no slightest clue what enema has to do with Valsalva menuver. :uhoh21:

[SuesquatchRN, BSN, RN]

I have no slightest clue what enema has to do with Valsalva menuver. :uhoh21:

An enema makes you poop. Pooping causes one to bear down and hold ones breath. That's the Valsalva maneuver.

[Nuieve]

An enema makes you poop. Pooping causes one to bear down and hold ones breath. That's the Valsalva maneuver.

I've never used one... I thought once enema is administered, it kinda just flow out by itself without any effort... :chair:

[MikeyJ, RN]

I've never used one... I thought once enema is administered, it kinda just flow out by itself without any effort... :chair:

Some of the fluid definitely will flow out without any effort, and if there isn't much in the colon, a great deal of it will flow out with no effort. However, some of the solution is kept in because of your the tight sphincter. And if you have any type of impacted or hardened stools (even though the enema definitely helps with softening the stools), it still requires effort to push it out.

[Nuieve]

Oh... thanks for clarifying... :)

[LaceyRN]

Would an unconscious patient have the ability to perform the Valsalva maneuver?

[mysterious_one, ASN, RN]

Would an unconscious patient have the ability to perform the Valsalva maneuver?

My thought , too????

[sirI, MSN, APRN, NP]

The unconscious individual cannot perform a valsalva maneuver. They must be conscious and able to follow directions.

The rationale regarding the enema is stimulation of the vagus nerve via anal stimulation, causes bradycardia, hypotension, syncope. Sometimes these sudden changes can elicit a cardiovascular event such as lethal arrhythmias, stroke, asystole ---->death.

So, administering enemas can elicit a vagal response and lead to devastating outcomes. Must be done using extreme caution.

[mysterious_one, ASN, RN]

I understand the danger of the valsalva maneuver in regards to cardiac events, but the rationale in the OP's statement states: " the Valsalva maneuver can increase intracraneal pressure". That to me, doesn't make sense in an unconscious patient?????:uhoh21:

[sirI, MSN, APRN, NP]

Exactly, mysterious_one

Appears the wording should be changed in the rationale OP gave from "...valsalva maneuver to vagal response".