administeration m

1. Administering a
Rectal Suppository
Presented By
Mrs.Usha Rani Kandula, MSc(N),
Assistant professor in Adult health nursing, Department of Clinical nursing,
Arsi University, College of health sciences, Asella, Ethiopia, Institutional email:
usharani2020@arsiun.edu.et.

3. RECTAL INSTILLATIONS
-Rectal instillations can be in the form of enemas, suppositories, and
ointments.
-Rectal ointments are used to treat local conditions and symptoms
such as pain, inflammation, and itching caused from hemorrhoids.
-Rectal suppositories are cone-shaped masses of substances
designed to melt at body temperature and to produce the intended
effect at a slow and steady rate of absorption.

4. -Suppositories provide a safe and convenient route for administering
drugs that interact poorly with digestive enzymes or have a bad taste
or odor.
-They are also used to provide temporary relief for clients who cannot
tolerate oral preparations: for example, to relieve nausea and vomiting.
-Suppositories are also used to induce relaxation, relieve pain and
local irritation, reduce fever, and stimulate peristalsis and defecation in
clients who are constipated.

5. -Rectal suppositories are contraindicated in cardiac clients because
insertion may stimulate the vagus nerve, causing cardiac dysrhythmias
(abnormal heart patterns).
-These drugs are also avoided in clients recovering from rectal or
prostate surgery because they may cause pain on insertion and
trauma to the tissues.
-The nurse should assess the rectum for irritation or bleeding and
check sphincter control.
-Some clients may experience problems in retaining the suppository.

6. -The nurse should instruct such a client to remain in the Sims’ position
for at least 15 minutes or should place the client on the abdomen, if the
condition allows, and hold the buttocks closed.
-The health care practitioner should be notified when the client is
unable to retain a suppository so that another route can be ordered.
-Suppositories are often stored in the refrigerator to preserve the
integrity of the drug form.

7. -A softened suppository is difficult to insert; to harden a suppository,
place it under cold running water while it is still in its original wrapper.
-The nurse should follow the rights of medication administration and
Standard Precautions when administering rectal instillations.

8. Equipment
 Medication administration record (MAR)
 Prescribed rectal suppository
 Water-soluble lubricant (such as K-Y jelly)
 Non sterile gloves
 Tissue
 Bedpan (optional)

9. Sl.No Action Rationale
1 Check with client and the chart for any
known or medical conditions that would
contraindicate use of the drug.
Prevents occurrence of adverse drug
reaction.
2 Gather necessary equipment. Promotes efficiency.
3 Check MAR against written health care
practitioner orders.
Ensures accuracy in identification of the
medication.
4 Wash your hands Reduces the transmission of
microorganisms.
5 Check the client’s identification
armband.
Ensures correct client.

10. Sl.No Action Rationale
6 Ask client if he or she needs to void. Client will have to remain in bed after
insertion of suppository.
7 Explain procedure to client. Enhances cooperation.
8 Don non sterile gloves. Decreases contact with body fluids.
9 Place the client in the Sims’, left-lateral
position, with the upper leg flexed.
Exposes anus and helps rectal sphincter
relax.
10 Fold back the bed linen to expose the
rectum.
Provides privacy.

11. Sl.No Action Rationale
11 Open the package of lubricant and
remove the foil wrapper from the
suppository.
-Read the manufacturer’s instructions
on the wrapper for the recommended
time interval the client should retain the
suppository after insertion.
Manufacturer’s instructions provide
important
information as part of the instructions for
the
client.
12 Apply a small amount of lubricant to the
smooth rounded end of the suppository
to
reduce mucosal irritation.
-Lubricate the gloved index finger.
Lubricant facilitates insertion and reduces
friction or pain as the suppository is
inserted into rectum.
13 Instruct the client to breathe through
the
mouth.
Relaxes sphincter and reduces chance of
pain.

12. Sl.No Action Rationale
14 Insert the suppository into the rectal
canal
beyond the internal sphincter, about 4
inches (10 cm) for an adult and 2
inches (5 cm) for a child (Figure 29-38).
-Avoid inserting the suppository into
feces.
Prevents the suppository from slipping out.
Suppository must be placed next to
mucosa to
facilitate absorption and enhance
therapeutic
action of the drug.
15 Withdraw the finger and wipe the anal
area with tissue.
Provides comfort.
16 Instruct the client to remain in bed for
15 minutes and to resist urge to
defecate.
Allows medication to be absorbed and
prevents expulsion of the suppository.
17 Remove gloves, turning them inside
out; dispose of gloves; wash hands.
Reduces transmission of microorganisms.
18 Record on the MAR the name of the
drug,
Provides documentation that medication
was

13. Sl.No Action Rationale
19 Observe for effect of suppository after
administration.
Evaluates effectiveness of medication.
Thanking you