The nurse is reviewing the different types of enemas with a group ...

[a0266361136]

The nurse is reviewing the different types of enemas with a group of nursing students. What would be the best description by a student nurse of a cleansing enema?
 
  A) Consists of a small amount of olive or cottonseed oil, given to protect or soothe the mucous membrane of the colon.
  B) Introduces enough fluid into the colon to soften feces, stimulate peristalsis, and produce a bowel movement that empties the rectum and lower colon
  C) Medication is inserted into the rectum in combination with a small amount of oil or saline to reduce its irritating effect and to lessen the client's desire to expel it.
  D) Given to stimulate peristalsis so that flatus is expelled from the intestine

Question 2

The nurse providing care in a long-term care facility knows that under Medicare's Pay for Performance (P4P) a facility's reimbursement is based on quality of care provided.
 
  This is based on how well the facility performs on pre-established quality measures. Publicly reported quality measures (PRQM) include the percentage of residents with which of the following? Select all that apply A) Respiratory infection
  B) Moderate to severe pain
  C) Pressure ulcers
  D) Malnutrition
  E) Placement in restraints
  F) Depression greater than when admitted

[juiceman1987]

Answer to Question 1

B
Feedback:
The cleansing enema introduces enough fluid into the colon to soften feces, stimulate peristalsis, and produce a bowel movement that empties the rectum and lower colon. The carminative enema is given to stimulate peristalsis so that flatus (gas) is expelled from the intestine, along with stool. An emollient enema consists of a small amount of olive or cottonseed oil given to protect or soothe the mucous membrane of the colon. The medicated enema inserts a drug into the rectum; sometimes, it is the only way to give a drug to a client, possibly because the client is vomiting, unconscious, or has had mouth or throat surgery.

Answer to Question 2

B, C, E, F
Feedback:
Four of these publicly reported quality measures (PRQM) include the percentage of residents with the following: moderate to severe painthe goal: through appropriate care measures and/or medication administration, the person will not experience break-through pain and his/her pain will be managed; pressure ulcersthe goal: care provided should aid in healing of wounds existing on admission and should prevent new pressure areas from developing; placement in physical restraintsthe goal: facilities are encouraged to work toward a restraint-free environment; and depression or anxiety greater than when the client was admitted to the facilitythe goal: counseling and medications should be provided to help alleviate mental health concerns.