A nurse is preparing to administer a soapsuds enema to an adult client. Which of the following actions should the nurse take?
Insert the tubing about 15 cm (6 in) into the anus.
Hang the enema container 61 cm (24 in) above the anus.
Assist the client to the left Sims' position.
Put on sterile gloves.
The Correct Answer is C
The left Sims' position (also known as the left lateral position) is the appropriate position for administering a soapsuds enema. This position allows for better visualization and access to the rectum and facilitates the flow of the enema solution.
The other options mentioned are incorrect:
Inserting the tubing about 15 cm (6 in) into the anus: The specific depth of insertion may vary depending on the client, but the general guideline is to insert the tubing about 3 to 4 inches into the rectum for an adult. 15 cm (6 in) would be excessively deep and could cause discomfort or injury.
Hanging the enema container 61 cm (24 in) above the anus: The height at which the enema container is hung should be no more than 18-24 inches (45-60 cm) above the anus. Hanging it too high can cause excessive pressure and discomfort during the administration.
Putting on sterile gloves: Sterile gloves are not typically required for the administration of a soapsuds enema. Clean gloves or non-sterile gloves are generally sufficient for this procedure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Sucralfate is a medication commonly used in the treatment of peptic ulcer disease. It works by forming a protective barrier over the ulcer site, providing a physical barrier against gastric acid, and promoting the healing process. When teaching a client about sucralfate, it is important to provide instructions regarding its proper administration.
One of the key instructions is to take sucralfate 1 hour before meals. This timing allows the medication to form a protective coating in the stomach before food is ingested. Taking sucralfate on an empty stomach enhances its effectiveness in protecting the ulcer and promoting healing.
"Take the medication with an antacid" - Sucralfate should not be taken with an antacid. Antacids can interfere with the protective mechanism of sucralfate by neutralizing stomach acid, which is necessary for sucralfate to bind and form a protective coating. It is recommended to wait at least 30 minutes to 1 hour after taking sucralfate before taking an antacid.
"Take as needed for pain relief" - Sucralfate is not typically used for immediate pain relief in peptic ulcer disease. It is primarily used for its protective and healing properties. Pain relief is
usually addressed with other medications, such as antacids, acid-reducing medications, or pain medications as prescribed by a healthcare provider.
"Store the medication in the refrigerator" - Sucralfate does not require refrigeration. It should be stored at room temperature, away from excessive heat or moisture, as per the specific instructions provided by the manufacturer or healthcare provider.
Correct Answer is C
Explanation
A.Docusate sodium should not be taken with mineral oil, as the combination can increase the risk of adverse effects and reduce the effectiveness of the medication.
B.Docusate sodium is primarily used to prevent constipation by softening stools, not for treating diarrhea.
C.Docusate sodium is a stool softener that typically works within 1 to 3 days to produce softer stools, making this statement a correct understanding of its effects and timeline.
D.While it’s important to stay hydrated when taking docusate sodium, the statement is somewhat misleading. It is typically recommended to take docusate sodium with a full glass of water to help facilitate the softening of stools.
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