Nurse Maria is administering a cleansing enema to a client with severe constipation. She will place client in which position?

Correct Answer: C. Left Sim’s position.

During a cleansing enema, place the client in the left Sim’s position to allow the solution to flow by gravity in the natural direction of the colon. Position the patient on the left side, lying with the knees drawn to the abdomen. This eases the passage and flow of fluid into the rectum. Gravity and the anatomical structure of the sigmoid colon also suggest that this will aid enema distribution and retention.

• Option A: Position the patient on his left side in Sims’ position or left lateral position with the right knee flexed, which will adequately expose the anus. This position allows the solution to flow downward by gravity along the curve of the sigmoid colon and rectum, thus improving the effectiveness of the enema.
• Option B: The ideal positions for enema administration are the left-side position and the knee-chest position. It is advised that the patient remains in one of these positions to receive the enema for one-third of the time.
• Option D: The left lateral position is the most appropriate position for giving an enema because of the anatomical characteristics of the colon. Although the length of the tube to be inserted is designated as approximately 5-6 cm, do not try to force it but pull it back slightly if any resistance is felt.