Performing an Enema on an Illeostomy Pt???

[skittlebear]

I have a patient tomorrow with an Illeostomy who has orders to give a tap water enema 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?

[skittlebear]

anyone?

[Elektra6, ASN, BSN, RN]

I had a patient on my LTC floor with an ileostomy. She had several obstructions but they were around the stoma site. Usually it was hardened feces blocking the stoma exit but once it was a whole almond I pulled out of there! I would question that order because she lost a TON of fluid with her ileostomy anyway. We had her on IV NSS q12h because of dehydration. Sorry I'm not more help.

[Fiona59]

I've done one a few years back. Recall using a foley in the stoma and gentle flush of saline via a 60cc syringe.

The order seemed whacky to us, but one of my co-workers had done it before and walked me through it. You need lots of soakers and a couple of pairs of hands for clean up.

Never seen another order for it since.

[hiddenheart]

On the floor that I am on, we have done several of them recently, some doctors want you to do them through the soma, and some want them in the rectum, but basically you do them the same way, with an enema kit. if it is through the stoma, make sure you have plenty of towels to soak up the fluid, it makes a mess.

[momnmotn]

My daughter has a colostomy and I irrigate it with tap water using a small foley it is ok you just need to be gentle my daughter has no rectal sphinchter so you would be unable to use the rectum since she has no muscle control to hold I know the speciality hospitals do this often.