Illeostomy pt and Enema????

[skittlebear]

I have a patient tomorrow with an Illeostomy who has orders to give a tap water enema in the rectum until clear due to an obstruction. Has anyone ever heard of this? Giving an enema to a patient that has an illeostomy? Also, I'm unfamiliar with exactly what the order reads...is there a limit to how many enemas this pt can receive...just until clear? Thanks to all who respond!

[NurseyPoo7]

I was always taught never put anything in the stoma

[madwife2002, BSN, RN]

There is another thread running this topic

https://allnurses.com/forums/f66/how-do-you-give-enemas-thru-colostomy-289004.html

[skittlebear]

I was always taught never put anything in the stoma

That's the thing...It's not an enema in the stoma but an enema in the rectum. Somehow, this pt has an obstruction and we are to give tap water enemas until clear. How often do you give the tap water enema...like every hour or something? Until it's clear? Just trying to become familiar with this before It happens.

[morte, LPN, LVN]

DOES the patient have an ileostomy, or is is (s)he s/p reconstruction......

it was clearly an ileostomy and not a urostomy...?

or what is the surgery where they take part of the intestine and make a new bladder.?......good luck

[Sunflowerinsc, ADN, RN]

Be sure you know what kind of ostomy the pt. has. Can you read the original surgical report? A ileostomy is the end of ileum pulled through the right lower side of abdomen after disconnected from the colon.

IF you know the kind of surgery ,it will be clearer whether the rectum has been removed. Some times for a temporary ileostomy ,the colon and rectum will be bypassed ,not removed.

Are you giving enemas until clear for surgery prep or testing? The surgeon should give clearer directions I should think.

Generally for enemas until clear, its just what it says, give as much fluid (in small amounts) until it comes back clear, no stool in it.

Of course ,monitor the pt as you go along. And follow hospital policy.

Good luck

[skittlebear]

Be sure you know what kind of ostomy the pt. has. Can you read the original surgical report? A ileostomy is the end of ileum pulled through the right lower side of abdomen after disconnected from the colon.

IF you know the kind of surgery ,it will be clearer whether the rectum has been removed. Some times for a temporary ileostomy ,the colon and rectum will be bypassed ,not removed.

Are you giving enemas until clear for surgery prep or testing? The surgeon should give clearer directions I should think.

Generally for enemas until clear, its just what it says, give as much fluid (in small amounts) until it comes back clear, no stool in it.

Of course ,monitor the pt as you go along. And follow hospital policy.

Good luck

The patient is in long term care and has had the illeostomy now for about 3.5 years. The colon and rectum was bypassed, not removed. The doctors are saying this pt is obstructed in her rectum which doesn't make any sense at all to me (due to the illeostomy), but this pt has a history of vomiting after she eats so her PCP thinks she is obstructed and ran test to prove as such. Anyway, the enema was given in the rectum and only clear fluid was returned...so, no such luck with the enema. I think the next step is a colonoscopy which personally I thought should have been the first step. I guess the whole illeostomy/obstruction in the rectum thing has me puzzled...unless the pt was obstructed before the surgery took place but it seems as though they would catch that???