Enema Types and Administration for Nurse Assistants: A Clinical Guide

Enemas a Nurse Assistant May Administer (Per Facility Policy)

Always follow provider orders, facility protocols, and state scope-of-practice regulations.

Type	Volume	Solution	Purpose	Key Points
Cleansing	500–1000 mL	Warm water, normal saline	Relieve constipation, prep for procedure	Lubricate tip; insert 3–4 in; elevate solution bag 12–18 in
Retention	50–150 mL	Medicated (steroids, antibiotics), nutrient	Local therapy, nutrition	Retain 15–30 min; patient in Sims' position
Carminative	Air/gas	Room air or O₂/CO₂ mix	Relieve gas distension	Use rectal tube; advance gently
Oil-Retention	100–200 mL	Mineral oil, olive oil	Soften impacted stool	Retain 1–3 hrs; may follow with cleansing enema
Soap-Suds	500–1000 mL	Castile soap solution	Stimulate peristalsis	Rarely used; mucosal irritation risk
Hypertonic	60–120 mL	Sodium phosphate, magnesium citrate	Draw water into colon	Pre-op prep; caution in renal/heart failure

Safety Essentials

• Verify order, patient ID, allergies.
• Explain procedure; ensure privacy.
• Monitor for distress, vasovagal response.
• Document: type, volume, solution, result, tolerance.