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Difficulty: EasyBasic Care and Comfort

A client on a medical-surgical unit requires a cleansing enema for relief of severe constipation. To facilitate the flow of the enema solution into the colon and promote retention, in which position should the nurse place the client?

  1. Left lateral with the right knee flexedAnswer
  2. B
    Right lateral with both legs extended
  3. C
    Supine with the head of the bed elevated 45 degrees
  4. D
    Prone with a small pillow under the pelvis

Answer

The correct answer is the left lateral position with the right knee flexed (Sims' position).
The left lateral position with the right knee flexed, also known as the Sims' position, is the standard positioning for enema administration. Because the descending colon and sigmoid colon are located on the left side of the body, this position allows gravity to assist the flow of the enema solution along the natural anatomical curve of the lower intestine. This maximizes fluid retention, reduces discomfort, and improves the overall effectiveness of the procedure.

Step-by-Step Solution

1
Recall the anatomical structure of the large intestine.
The descending colon and sigmoid colon are located on the left side of the abdomen.
Understanding anatomy is required to determine how fluid will flow into the body.
2
Determine the effect of gravity on fluid administration.
Placing the client on their left side allows gravity to pull the instilled fluid downward into the sigmoid and descending colon.
Gravity facilitation ensures the fluid reaches higher up into the colon, maximizing the effectiveness of the enema.
3
Identify the standard clinical position matching this anatomical need.
The left lateral position with the right knee flexed (Sims' position) is identified as the optimal choice.
This position provides optimal exposure of the anus for the nurse while utilizing anatomy and gravity to promote fluid retention and client comfort.

Key Concept

Basic Care and Comfort: Bowel Elimination and Positioning
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Topics

Basic Care and Comfort

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